Pole Cruise 2028 Registration Form

Full Name (as per ID - Licence, Passport, Birth Cert etc)

First NameLast Name

Email

example@example.com

DOB

Date

Citizenship (Australian, English, American etc)

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Pole Level (Estimate only)

Pole Studio

Roommate #1 (if applicable) - leave blank if you need us to find you a roomie

First NameLast Name

Roommate #2 (if applicable)

First NameLast Name

Roommate #3 (if applicable)

First NameLast Name

**SOLO TRAVELLERS** - We will do our best to pair you with another solo traveller who has requested the same room type as you. Should there not be another solo traveller with the same room type, we will reach out to you both to agree on a room type to lock in (any payment plans will be updated to reflect increase/decrease of pricing). If an agreement can not be made and we can not find you a room mate, your booking may be cancelled.

Pairings may be same or mixed gender, depending on who requires a pairing.

Dietary Requirements

Other

Emergency Contact

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Terms & Conditions

Signature

Cabin Type

Payment Plan Deposit

Please note your first payment will be due on the 1st day of the following month.

$500.00 AUD Cabin Type

Inside Twin Share

Full Payment option - p/p

$1,990.00 AUD

Inside Triple Share

Quote available on request - please reach out to info@eastcoastpolecruise.com.au before booking

$1,875.00 AUD

Inside Quad Share

Quote available on request - please contact info@eastcoastpolecruise.com.au before booking

$1,850.00 AUD

Oceanview Twin Share

Full Payment option - p/p

$2,200.00 AUD

Balcony Twin Share

Full Payment option - p/p

$2,550.00 AUD

Balcony Triple Share

Quote available on request - please contact info@eastcoastpolecruise.com.au before booking

$2,200.00 AUD

Enter coupon

Total

Payment Methods
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Pole Cruise 2028 Registration Form

Cabin Type*

Cabin Type