A deposit of 25% or full payment is required on booking.

One Booking Form Per Person Please

First Name

Last Name

Address

Phone

Emergency Home Contact

I have Special Needs

Gender Male Female

I require accommodation Yes No

Days attending Saturday Sunday Monday

Costs per day

Single accommodation & meals	$130.00
Twin/double accommodation & meals	$120.00
Marae style mattress & meals	$105.00
Camping & meals	$105.00

Costs

Walk,lunch, bus Saturday (no accommodation)	$70.00
Walk,lunch, bus Sunday (no accommodation)	$70.00
Walks, BBQ, Monday only	$50.00

Total Cost $

I will share my room with this person

Payments

A deposit of 25% or full payment is required on booking.

Payment can be made by either Internet banking or cheque.

Please include your name as the reference so we can reconcile payments with bookings

Please make all via Internet Banking to:
Bank: ANZ
Account: Waipukurau Rotary
Account #: 01 0778 0015668 05

Please make all cheques out to Waipukurau Rotary and send them to

Sea Sky Bush Walk
PO Box 279
Waipukurau 4242