Submit Delegate

Name

First name: *

Last name: *

*Note: if you require air travel please enter your name exactly as it appears on your passport (international flights) or driver's license (domestic flights)

Professional Details

Delegate Type: *

Company/Outlet: *

Position: *

Contact Information

Phone (Business hours): *

Mobile/Cell Phone: *

Email: *

Name Badge

Name as it will appear on your name badge: *

Organisation/Affiliation as it will appear on your name badge: *

Travel

For the following flights, ground transfers from Sunshine Coast airport to Novotel Twin Waters and back will be arranged for you. The driver will be waiting for you with a "MediaConnect/Kickstart Forum" sign.

If the flight you require is not listed below please call Cassandra Lane on (02) 9894 6277 with your alternative requests. Please note an additional fee may apply.

Flight membership number:

Where relevant we will add any frequent flyer or loyalty membership numbers to your bookings.

To Kickstart: Sunday 2nd March:

Return: Tuesday 4th March:

Accommodation

Accommodation will be at Novotel Twin Waters Resort in their newly refurbished resort rooms. No delegates will be required to share accommodation.

Please check which nights you require accommodation at Novotel: *

Sunday night 2nd March

Monday night 3rd March

I do not require accommodation

Special requirements

State any special requests here and we will do our best to accommodate them.

Meals:

e.g. Vegetarian

Medical:

e.g. a disability we need to be aware of.

Terms and Conditions

An official confirmation including travel and accommodation bookings will be emailed to you by Cassandra Lane within 7 days. If you need to make any changes to your bookings after email confirmation a change fee may apply plus any additional fare increases.

Important information regarding the Kickstart Forum is also available on this website. Submitting this registration form confirms that you have read and understood the information provided. Please note that although all requests are passed on in writing to the hotel and airlines, allocations are completely beyond our control. All cancellations and amendments must be made directly with MediaConnect and received in writing. Please email cassandra@mediaconnect.com.au.

Click the Submit button below if you are happy with your selections and you will be redirected to the homepage. Thanks!

Submit Delegate

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