Apr 11, 2014 - MEMBERS ROAD TRIP 2014. DATE: Friday 11 ... Names of members attending: Name. Adult/Junior ... Visa. Mast
MEMBERS ROAD TRIP 2014 DATE: Friday 11 April | VENUE: Robina Stadium TIME: 4.45pm onwards (please select your chosen pick up location below) RSVP: Tuesday 8 April 2014 Cost: $50.00 per Adult/Concession | $35.00 per Junior*
BOOKING FORM Name:
Member Number:
Email:
Phone:
Names of members attending: Name
Adult/Junior
Ticket Type
Price (Incl. GST)
Adult/Concession
$50
Junior*
$35
Quantity
Total
TOTAL Please choose a pick up point (more specific details regarding the meeting point will be emailed to you): Meeting Point
Time
Broncos Leagues Club, 92 Fulcher Road, Red Hill
4.45pm
Broncos Gymnasium, Fulcher Road, Red Hill
5.10pm
John Paul College, John Paul Drive, Daisy Hill
5.30pm
Please tick one
Payment Details Visa
MasterCard
American Express
Credit Card Number:
Expiry Date:
Cardholders Name:
CVC:
/
Cardholders Signature: Please debit my card for:
Terms & Conditions Payment in full is required at the time of booking. Notification of cancellation must be made in writing 5 days prior to the event to receive a refund. Any cancellations after this time or nonattendance will result in full payment. All members on one form will be seated together. If you wish to sit together please use just one form. By booking to attend you give authority for the club to take photographs that may be used for any future promotional purposes, without requesting further consent *Junior = 4-14 years of age and may be required to provide school I.D. Under 4 years of age is free if seated on knee of accompanying Adult at the game.
TO BOOK: Email
[email protected] | Call 1300 GO BRONCOS (1300 46 2766) Post to Shay Peady, Broncos Membership Department, Locked Bag 3003, Paddington, QLD, 4064
