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Pricing
Summit - Single	$170.00
Summit - Couple -	$340.00
Download a Registration Form

Registration Details

Fields with a * are compulsory

Personal Details

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Title

First Name

* If registering as a couple, you may enter your spouses name in Step 4

Last Name

Street Address

Suburb

City

Postcode

* Find your postcode

Home Phone

Mobile

Emergency Contact:

Emergency Contact

Emergency Contact Phone

For Our Information

Fields with a * are compulsory

Age Group

Church Name

Denomination

Other:

City

Registraton Fee

Fields with a * are compulsory

	Single Registration	Couple Registration
Summit	$170.00	$340.00

Other Options

Fields with a * are compulsory

Spouse Name if registering as a couple

I will be bringing a baby

I have read and accept the Privacy Act conditions

Please tick here if you do not want to receive information about future conferences

Refund Policy

Any amendments and/or refunds must be made in writing to the Summit organisers. Cancellations received in writing before 4 January 2012 will receive a refund, less an administration fee of NZ$35. No refunds will be made to cancellations received after 5 January 2012. Your registration and payment are confirmation you have read and accepted these terms and conditions. Any enquiries, phone 09 306 4222.

Conference Contact Details

LIFE
95 Mt Eden Rd
Auckland

P.O Box 108138
Symonds St
Auckland 1150

P. 09 306 4225
F. 09 306 4223
E. getsmart@lifenz.org

Pricing

Registration Details

Personal Details

For Our Information

Registraton Fee

Other Options

Refund Policy

Conference Contact Details