2022 Annual Conference Registration 53rd ANNUAL CONFERENCE, Sydney West HQ 33 Railway ST, Rooty Hill NSW 2766 12th-16th October 2022 Closing date for Registration is Friday 23rd September, 2022. Registrations received by Monday 15th August, 2022 qualify for Early Bird Prize of $250 Please book your own accommodation using the accommodation information provided. 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. After you send your form, please check the message that will appear under the 'Send' button. This will tell you if your submission has been successful or if you have omitted any required fields. Your Name (required) Your Email (required) Address (required) Suburb, State & Postcode (required) Phone Number (required) Format: 10 digits including area code Where Staying (required) Inner Wheel Club (required) Inner Wheel District (required) A40A50A51A53A54A55A60A61A62A70A76A77A80 Inner Wheel Position 2022-2023 Highest Inner Wheel Position Mobility Constraints? 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 12 October Registration - West HQ (33 Railway St, Rooty Hill, 2766) 1.00pm - 5.00pm Free Night Thursday 13 October Breakfast for DC/VC/JVC - 7:00am - 8:30am Cost $26.00 Attendee Member Partner N/A Cost $26 Registration - West HQ 8.00am - 9.30am and 1.30pm - 5.00pm Opening Ceremony Ambassador Room West HQ 10.30am for 11am. Cost No Charge* Attendee/s MemberPartner Forum and Workshops Conference Rooms West HQ 2.00pm - 3.30pm Cost No Charge* Attendee/s MemberPartner *Please ensure attendees are indicated for No Charge sessions Welcome Dinner - Ambassador Room West HQ "Celebrating Friendship in Colour" 6.30pm - 10.30pm Cost $62 per person Attendees MemberPartner Cost @ $62 per person $62$124 SUB TOTAL this section 13 October Friday 14 October Registration - West HQ 8.00am - 11.00am and 2.00pm - 4.00pm Council Meeting Conference Room 4 West HQ 8.30am - 4.00pm Attendee Member Partner N/A Optional Tours Blue Mountains bus only: 9.00am - 3.30pm Cost $40 per person Attendee/s MemberPartner Cost @ $40 per person $40$80 Ebeneezer/Winery all inclusive: 9.00am - 3.30pm Cost $75 per person Attendee/s MemberPartner Cost @ $75 per person $75$150 Walking Rocks Tour: 9.00am - 3.30pm Cost $35 per person Attendee/s MemberPartner Cost @ $35 per person $35$70 Friendship Dinner - Ambassador Room West HQ - WEAR PASTELS 6.30pm - 10.30pm Cost $65 per person Attendee/s MemberPartner Cost @ $65 per person $65$130 SUB TOTAL this section 14 October Saturday 15 October Registration - West HQ 8.00am - 8.30am Business Session, AGM & IIW President Address 8.30am - 3.30pm Ambassador Room West HQ (Morning Tea & Lunch) Cost $37 per person Attendee/s MemberPartner Cost @ $37 per person $37$74 Saturday Men's Tour: 9.00am - 4.00pm Cost $50 per person Attendee/s MemberPartner Cost @ $50 per person $50$100 Gala Dinner - Ambassador Room West HQ - Black & White with a touch of bling 6.30 - 10.30pm Cost $70 per person Attendee/s MemberPartner Cost @ $70 per person $70$140 SUB TOTAL this section 15 October REGISTRATION FEE Registration Fee is $35 per person Attendee/s (required) MemberPartner Cost @ $35 per person (Required) 0$35$70 SUBTOTAL this section (Registration) (required) Registration Fee applicable for one event or session only Cost @ $20 per person (Required) $0$20$40 SUBTOTAL this section (One event 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 032576 Account No. 162930 Inner Wheel Australia Inc Conference 2022 Please insert your surname and club in reference section Cheque: Post to Conference Registrar Diana Howes, PO Box 100 Kemps Creek NSW 2178 Phone 0418 977 232