Taituara 45 South Retreat Registration Form

Taituara 45 South Retreat Registration Form
Full Name*

First NameLast Name
Council/Organisation*
Email*
example@example.com
Name for nametag*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
YesNo
YesNo
YesNo
Please detail any dietary requirements you have:*
Registration cost $550 (plus GST $632.50). Please make payment to the Gore District Council bank account 030915-0289519-00 and include your name and the words Taituara Retreat as reference.

A reciept will be issued.
YesNo
Please note, Edgewater Resort will be requiring all guests aged 12 and over entering its hotel facilities to produce their vaccine pass.
Should be Empty: