2023 Conference Registration 55th ANNUAL CONFERENCE, Cowes - Phillip Island, Victoria Cowes Primary School Gymnasium, 177 Settlement Road, Cowes 3922 11th-14th October 2023 Closing date for Registration is Friday 8th September, 2023. Registrations received by Monday 4th August, 2023 qualify for Early Bird Prize of $250 Conference Venue is Cowes Primary School, 177 Settlement Road, Cowes Victoria 3922. Please book your own accommodation using the accommodation information enclosed. Details of accommodation set aside for IWA Executive, IWA Editor, Council Members, and Appointed Officers will be emailed during July for your confirmation. The Conference venue has wheelchair access to all areas. Please PRINT when completing this form. Members and Partners should share a form. Please complete a separate form for each Club member attending when the Club is making a single payment for registrations. MEMBER Your Name (required) Your Email (required) Address (required) Suburb, State & Postcode (required) Phone Number (required) Format: 10 digits including area code Inner Wheel Club (required) Inner Wheel District (required) A40A50A51A53A54A55A60A61A62A70A76A77 Inner Wheel Position 2023-2024 Highest Inner Wheel Position Mobility Constraints? Where Staying (required) Own Transport to venues? (required) —Please choose an option—yesno Require bus? (required) —Please choose an option—yesno Dietary Requirements - Please detail MEDICAL REQUIREMENTS ONLY Name Dietary Requirement Name Dietary Requirement Accompanying Partner/Guest Name Partner/Guest Telephone Partner/Guest Mobile Partner/Guest Medical Dietary Requirements Partner/Guest Mobility Constraints Wednesday 11 October Registration - Registration, Teller & House of Friendship. Venue – Uniting Church Hall, Cnr Chapel & Warley 1.00pm - 4.30pm No Cost Optional Dinner & Penguin Parade - 5.30pm - 9.30pm Little Penguin Café, at Penguin Parade, Ventnor Rd Dinner & Penguin Parade $55 per person Attendees MemberPartner Cost @ $55 per person $0$55$110 Dinner Only $35 per person Attendees MemberPartner Cost @ $35 per person $0$35$70 Transport if required : Cost $15.00 per person MemberPartner Transport Cost @ $15 per person $0$15$30 SUB TOTAL this section 11 October Thursday 12 October Cowes Primary School - 9:00am - 10:00am Registration & Teller - 2.30pm - 4.00pm District Chairman's Breakfast incl. VC & JVC - 7.00am - 9.00am Cost $20.00 Attendee Member Partner N/A Cost $0$20 Opening Ceremony - Cowes Primary School - 10.30am - 12pm Cost No Charge* Attendee/s MemberPartner Lunch - 12.00pm - 1.00pm Cost $20 Attendee/s MemberPartner Cost @ $20 per person $20$40 Forum - Q & A - 1.00pm - 2.00pm Cost No Charge* Attendee/s MemberPartner *Please ensure attendees are indicated for No Charge sessions Welcome Dinner - Beach Party Cowes Primary School, 'Dress to the Theme' - 6.30pm - 10.30pm Cost $50 per person Attendees MemberPartner Cost @ $50 per person $50$100 Transport if required : Cost $10.00 per person MemberPartner Transport Cost @ $10 per person $0$10$20 SUB TOTAL this section 12 October Friday 13 October Council Meeting Nobbies Centre - Council Members - 8.30am - 4.00pm Attendee Member Partner N/A Optional Tours 1) San Remo, Seal Rocks, Nobbies : 9.30am - 3.00pm Cost $30 per person Attendee/s MemberPartner Cost @ $30 per person $30$60 2) Churchill Island : 9.30am - 1.00pm Cost $40 per person Attendee/s MemberPartner Cost @ $40 per person $40$80 Registration & Teller - 2.00pm - 4.00pm Gala Dinner - Floral Fantasia Cowes Primary School, Dress: Formal/Lounge 6.30pm - 10.30pm Cost $60 per person Attendee/s MemberPartner Cost @ $60 per person $60$120 Transport if required : Cost $10.00 per person MemberPartner Transport Cost @ $10 per person $0$10$20 SUB TOTAL this section 13 October Saturday 14 October Registration - Cowes Primary School - 8.00am - 8.30am Business Session, AGM & Keynote Speakers (Morning Tea & Lunch) - 8.30am - 3.30pm Cost $35 per person Attendee (no partners) Member Cost @ $35 per person $35 3) Saturday Men's Tour: Vietnam Veterans Museum, San Remo, Grand Prix Track & Museum 9.30am - 4.00pm Cost $45 per person Attendee Partner Cost @ $50 per person $45 Friendship Dinner - Rock & Roll Cowes Primary School - 'Dress to the Theme' - 6.30 - 10.30pm Cost $45 per person Attendee/s MemberPartner Cost @ $45 per person $45$90 Transport if required : Cost $10.00 per person MemberPartner Transport Cost @ $10 per person $0$10$20 SUB TOTAL this section 14 October REGISTRATION FEE Registration Fee is $45 per person Attendee/s (required) MemberPartner Cost @ $45 per person (Required) $45$90 SUBTOTAL this section (Registration) (required) TOTAL COST (GST Inclusive) (Required) Please ensure you add together all sub totals from each section PAYMENT Please indicate payment method: Electronic Funds Transfer (EFT)Cheque Please make payment after completing this form and submitting. EFT: Westpac Bank BSB 032-539 Account No. 489053 Inner Wheel Australia Inc. Please insert your surname and club in reference section Cheque: Post to Conference Registrar Alwyn Williams, 21a Meeking Drive Pakenham VIC 3810 Phone 0419113815