MATCH DAY VIP BOOKING FORM

1. CUSTOMER CONTACT DETAILS Company Name: Contact Name: Postal Address: Suburb: State: Postcode: Phone: Email:

2. INDIVIDUAL MATCH SELECTION (CAN SELECT MULTIPLE BOXES)

TOTAL ADELAIDE MELBOURNE MELBOURNE FACILITY PRICE STRIKERS RENEGADES THUNDER SCORCHERS STARS PER HEAD/PER WED 19 DEC 2018 THURS 10 JAN 2019 THURS 17 JAN 2019 FRI 01 FEB 2019 FRI 08 FEB 2019 GAME 6:15PM 6:15PM 6:15PM 7:40PM 7:40PM

8 Person Outdoor Box $120 $960 $960 $960 $960 $960

10 Person Outdoor Box $120 $1,200 $1,200 $1,200 $1,200 $1,200

12 Person Suite $138 $1,650 $1,650 $1,650 $1,650 $1,650

18 Person Suite $122 $2,200 $2,200 $2,200 $2,200 $2,200

*All Prices GST Inclusive

Please note, prices above exclude food and beverage. The Heat will contact you within 48hrs of processing your booking to assist you with arranging catering directly with the stadium’s catering provider. Please call 3292 3181 if you require any further assistance.

3. SEASONAL OPTION (ALL FIVE HOME MATCHES) 4. DOUBLE HEADER

FACILITY TOTAL PRICE SEASONAL PRICE I will be attending 19 Dec 2018 PER HEAD/PER GAME ALL 5 HOME GAMES at 1.50pm.

8 Person Outdoor Box $88 $3,520 I will be attending 10 Jan 2019 at 12.50pm. 10 Person Outdoor Box $88 $4,400 Please indicate above if you would like to attend the WBBL Double 12 Person Suite $100 $6,000 Header’s at The Gabba.

Please note additional steward charges may apply. 18 Person Suite $84 $7,560

20 Person Suite (Seasonal Only) $84 $8,400

*All Prices GST Inclusive

Please note, prices above exclude food and beverage. The will contact you within 48hrs of processing your booking to assist you with arranging catering directly with the stadium’s catering provider. Please call 3292 3181 if you require any further assistance.

BRISBANEHEAT.COM.AU 07 3292 3100 [email protected] 5. TOTAL AMOUNT PAYABLE $

6. AUTHORISATION I agree to purchase the above benefits and have the authority to enter into this agreement with the Brisbane Heat. Name: Position: Signature: Date:

7. PAYMENT (VIA CREDIT CARD OR BANK DEPOSIT ONLY) As per the corporate terms and conditions, corporate tickets will not be issued until full payment is received. Bank Deposit: Please leave company name or surname as reference

Name: Association BSB: 064-000 Acc No: 1294 4060

Credit Card Details: Total Amount to be charged to credit card $ Credit Card Type: Card No: Card Name: Expiry Date: CCV: Signature:

Please note a fee will apply in respect to all credit card purchases – AMEX: 1.5% | VISA/Mastercard: 1.5% Please send a tax invoice to the above address Or provide an alternative address

8. FACILITY ALLOCATION (OFFICE USE ONLY)

BRISBANEHEAT.COM.AU 07 3292 3100 [email protected]