IMAGINATION REGISTER NOW

Halogen Foundation Ltd ABN 22 085 015 407 or or T: 02 9894 4561 F: 02 8211 5194 ONLINE: FAX: EMAIL: E: @halogen.org.au REGISTER ONLINE AT FILL IN YOUR DETAILS, SCAN AND EMAIL PO Box 1911 halogen.org.au PHOTOCOPY AND FAX THIS FORM TO North NSW 2059 THIS FORM TO [email protected] 02 8211 5194

Your confirmation and tax invoice will be sent to the email provided. Follow us on: Go online for up-to-date information and confirmed speakers. Ticket wristbands will be mailed to you 1-2 weeks before the event. Halogen Australia

SCHOOL NAME: YES! WE WOULD LIKE TO ATTEND THE PRIMARY EVENT IN: SCHOOL POSTAL ADDRESS: SYDNEY 03/03/17 20/03/17 13/03/17 27/03/17 SCHOOL PHONE: 17/03/17 SCHOOL FAX: SCHOOL EMAIL: STUDENT TICKETS @ $55.00 ($49.00 IF BOOKED BEFORE 9/12/16) STAFF CONTACT NAME: ADULT TICKETS @ $25.00 STAFF CONTACT POSITION: Book 11, only pay for 10! STAFF CONTACT EMAIL: For every multiple of 11 student tickets booked you only have to pay for 10, the 11th is free! PRINCIPAL’S NAME: PRINCIPAL’S EMAIL: ACCOUNTS EMAIL:

By making this booking, you agree to the Booking and Payment Policy below.

UPDATED BOOKING, PAYMENT AND CANCELLATION POLICY AS OF 1 APRIL 2016 Once a booking is made, payment is required within 30 days. Additional tickets can be purchased at any time, subject to availability. Cancellation of tickets must be made before 5pm, seven (7) days before the event day and received in writing via fax or email only, no refunds will be given a er this time. Part or full refunds requested within four (4) weeks of the event will incur a 20% fee of the value of tickets cancelled. Please note payment a er the event date will incur a $100 late fee. Please refer to our website for our full Booking, Payment and Cancellation Policy. DISCLAIMER Highlights of the events and identifiable images of event participants will be captured in both photographs and videos. Halogen Foundation reserves the right to use this material for commercial purposes in print, electronic and social media unless consent is explicitly denied by the individual concerned, their legal guardian or school. Please read the privacy policy on the Halogen Foundation website for more information.