Please print this form and fill in one for each participant, then either

post to Joyce Fisher at PO Box 2460, Green Hills. NSW 2323 Australia

or fax 0061 2 49 34 8878

or email to Joyce [To email - copy this form (press Ctrl A to highlight form, then press Ctrl C to copy form), paste into new email form (ctrl V) after clicking here, and fill in details]

First name:
Last name:
Organisation:
Postal address:
Postal address cont:
City:
Postcode:
Phone (include area code):
Mobile:
Work Email:
Home Email: 
Name required on receipt:
Is this your first workshop with Daf?    Yes    No
Which workshop are you registering for (including City & Date) ?  
 

PAYMENT METHOD? Cheque   Direct Credit (delete one)

Note: CREDIT CARD facilities are not available at present.
          
Please make cheque out to:
Viva Wellbeing and post to Joyce Fisher, PO Box 2460, Greenhills. NSW. 2323. Australia

or for Direct Credit (FOR NEW ZEALAND ONLY) either online or at bank

Please read the following instructions and deposit at any Westpac Bank in New Zealand to:
Viva Wellbeing      BSB 03 1707      Account Number  0120641 00

(Instructions: If depositing online ensure the name of participant is included as part of deposit information, or if depositing at a bank, ask teller to add bank number to deposit  AND email Joyce with date of deposit & bank number, otherwise your payment may not be correctly allocated – (If you have not received confirmation of payment within 10 working days, please contact Joyce)

Receipts will be issued at workshop

Cancellation Policy   
If unable to attend, registration may be transferred to a nominated replacement. 
Otherwise a full refund for cancellations is paid up to 5 days prior to workshop. 
If cancellation received less than 5 days prior to workshop then $50.00 will be deducted from refund. 
Please notify cancellations by email to Joyce on one of the above email addresses
If unable to cancel by day of workshop there is no refund, however a full copy of notes will be posted to you.