Summer Breeze Conference 2011

Register / Booking Form

Please complete the following form to register for the Summer Breeze Conference. Once you have clicked on 'Submit' to register your booking, you can then click on the online payment link to make payment (via credit card or internet bank transfer).

If you are wanting to make a group booking, please contact the school office first on 823 1800 or email registration@capernwray.org.nz  

* Required

Title DR MISS MR MRS MS

First Name *

Last Name *

Email Address *

Postal Address

Town

Post Code

Phone

Cell Phone

Emergency Contact (Name)

Phone (emergency)

Cell Phone (emergency)

Special Diet Needs:

Cost -- Please select -- Single - Full Residential $149 Couple - Full Residential $275 Single - Non-Residential $99 Child - $99

>> click here for online payment <<

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