2017 LGA Conference and Annual General Meeting - LGA Members Registration Form2017 LGA Conference and Annual General Meeting - LGA Members Registration FormPrint Wednesday 15 and Thursday 16 November at Adelaide Oval * Mandatory Field Delegate Details Council* Other Adelaide City Council Adelaide Hills Council Adelaide Plains Council Alexandrina Council Barossa Council Barunga West (District Council of) Berri Barmera Council Burnside (City of) Campbelltown City Council Ceduna (District Council of) Charles Sturt (City of) Clare and Gilbert Valleys Council Cleve (District Council of) Coober Pedy (District Council of) Coorong District Council Copper Coast (District Council of) Elliston (District Council of) Flinders Ranges Council Franklin Harbour (District Council of) Gawler (Town of) Goyder (Regional Council of) Grant (District Council of) Holdfast Bay (City of) Kangaroo Island Council Karoonda East Murray (District Council of) Kimba (District Council of) Kingston District Council Light Regional Council Lower Eyre Peninsula (District Council of) Loxton Waikerie (District Council of) Marion (City of) Mid Murray Council Mitcham (City of) Mount Barker District Council Mount Gambier (City of) Mount Remarkable (District Council of) Murray Bridge (Rural City of) Naracoorte Lucindale Council Northern Areas Council Norwood Payneham and St Peters (City of) Onkaparinga (City of) Orroroo Carrieton (District Council of) Peterborough (District Council of) Playford (City of) Port Adelaide Enfield (City of) Port Augusta (City of) Port Lincoln (City of) Port Pirie Regional Council Prospect (City of) Renmark Paringa Council Robe (District Council of) Roxby Downs (Municipal Council of) Salisbury (City of) Southern Mallee District Council Streaky Bay (District Council of) Tatiara District Council Tea Tree Gully (City of) Tumby Bay (District Council of) Unley (City of) Victor Harbor (City of) Wakefield Regional Council Walkerville (Corporation of the Town of) Wattle Range Council West Torrens (City of) Whyalla (Corporation of the City of) Wudinna District Council Yankalilla (District Council of) Yorke Peninsula Council Other Organisation Postal Address Delegate Title* Please select your title Mayor Cr Mr Mrs Ms Miss Dr Delegate First Name* Delegate Surname* Post nominals Delegate Position* Eg CEO, Finance Manager etc Delegate Special Requirements (eg dietary or other) Email* Contact for person completing the online form Phone Number* Your Contact Details I give permission for my contact details to be provided to the event sponsors This event can only take place with the help of our sponsors - by selecting this box you are giving your permission for your contact details to be shared with our sponsors. Registration Options Full Conference Pass (both days and dinner) - $610 + GST* Yes No Conference 2 day pass (excludes dinner) - $500+GST* Yes No Day 1 Pass (Wednesday) - $380 + GST* Yes No Day 2 Pass (Thursday) - $200 + GST* Yes No Dinner Pass (Wednesday evening) - $170 + GST* Yes No Partner Dinner Pass (Wednesday evening) - $170 + GST* Yes No Partners name Partners dietary requirements Optional tours As the conference is at Adelaide Oval we would like to offer two optional tours after the conference. The Roof Club (https://roofclimb.com.au/) and Adelaide Oval Tour. Adelaide Oval have offered these tours at a discounted rate (subject to numbers). If you are interested in either of these options can you please select yes below. Please note this is an expressions of interest and these tours will run subject to numbers. Both tours will run after the formal lunch on day 2 (approx 2.30pm) Please contact firstname.lastname@example.org if you have any questions. Adelaide Oval Roof Club - $89 (approx 2.5 hours) Yes No Adelaide Oval Tour - $15 (1hour) Yes No Payment and Cancellation Policy Payment An invoice will be sent to your Council/Organisation after the event for payment. Cancellation Policy If a person registered to attend this event is unable to do so, Councils/Organsiations are encouraged to notify the LGA and send a substitute. All cancellations must be received in writing / email at least 5 days prior to the conduct of the event, otherwise payment will be retained to cover costs which the LGA incurs following the cancellation date. I have read and understand the cancellation policy* If you see this, leave this form field blank. Email Submitted Data Send a copy of the submitted form to this email address.