Form

Booking Form

WHEN: Wednesday 28 November, 2018 commencing 6:30pm WHERE: Plaza Ballroom, Brisbane Convention & Exhibition Centre DRESS: Black Tie PRICE: $175 per person
Organisation *
Contact Person *
E-mail *
Contact Number *
No. of tickets @ $175 pp
No of complimentary tickets
e.g. finalist
Guest Name 1 *
Guest Name 2
Guest Name 3
Guest Name 4
Guest Name 5
Guest Name 6
Guest Name 7
Guest Name 8
Guest Name 9
Guest Name 10
Please advise any dietary requirements or special needs.
Please advise any other information required for this booking .
An invoice will be emailed on receipt of this form.

NO REFUNDS WILL BE MADE AVAILABLE FOR CANCELLATIONS AFTER WEDNESDAY 20 NOVEMBER
Please note actual tickets are not issued; registered names will be checked at the door.
Please return this form by Wednesday 20 November. For more information email kylie@qsport.org.au
Should be Empty:

Booking Form