Festival Dates / Sunday 20th January 2019 inclusive to / Friday 25th January 2019
First Name as in passport: / Calculate Your Registration Fee
Last Name as in passport:
Spouse/Partner Name as in passport: / Item:
Street Address Line 1: / Player Registration @ AUD $425 / $
Street Address Line 2: / Non-Player Registration @ AUD $250 / $
City/ State/ Postcode: / Strath Creek as Player @ AUD$70 / $
Country: / Strath Creek as Non-Player @ AUD $40 / $
MCG Tour (January 19 10.15am) @ AUD $20 / $
Phone Number: Include Country Code / MCG Tour (January 20 10.15am) @ AUD $20 / $
Email Address: / MCG Tour (January 23 10.15am) @ AUD $20 / $
Rotary Club: / MCG Tour (January 26 10.15am) @ AUD $20
RI Membership Number:
Rotary District:
Vegetarian? / ☐ Yes ☐ No / Total Payment (Australian Dollars): / $
Other Dietary Requirements:
Playing Status
Staying at Bayview Hotel? / ☐ Yes ☐ No
If No Accommodation Location: / Batsman / ☐ Yes ☐ No
Registration Instructions: / Bowler / ☐ Yes ☐ No
Print & Scan form,then email to: / / Wicket Keeper / ☐ Yes ☐ No
OR Post to: / Melbourne 2019 Festival,
18 Chatham Rd, Canterbury 3126
Payment Instructions: / Payment Dates:
Direct debit to: / IFCR Australia Melbourne 2019 Festival
Bendigo Bank – Maryborough Vic 3465 / BSB: 633 000 Account: 160081907 / 50% deposit to be paid April 30th 2018
All Direct Payments: / Include Last name in Reference Panel / Balance to be paid by August 31st 2018
Instructions to Overseas Applicants: / Quote Swift Code: BENDAU3B
Registration Form Part 2
Release and Indemnity
International Fellowship of Cricketing Rotarians
Melbourne Festival, January 2019
1.I, am aware and acknowledge that the above festival involves inherent risks, including the risk of injury to life or death and damage to property and in undertaking such activities, I do so at my own risk.
2.I am also aware that it is a condition of participation in the festival that Rotary, its officers and employees. agents and volunteers are released by me from all liability howsoever arising from injury or damage to both property and person howsoever caused (whether fatal or otherwise) arising out of my participation in the event whether or not such injury or damage is due to any negligent act, breach of duty, default and/or omission on the part of Rotary, its officers and employees, agents or volunteers.
3.I indemnify Rotary, its officers and employees, agents and volunteers against all loss, damage and expenses (including legal costs on a solicitor and own client basis) arising out of or in connection with any claims, actions, proceedings or demands of any kind arising directly or indirectly as a consequence of my participation in the event.
4.I acknowledge and agree that my participation in the event is as a consequence of my own free will and desire and that I have read and understood the above warning, release and indemnity.
5.I warrant that I am 18 years of age or older and am lawfully able to enter into this above release and indemnity or, in the event that I am a minor, I have the permission of my legal guardian to participate in the event and that my legal guardian has agreed to adhere to the terms of the indemnity below.
Signed
Dated this day of
Registration Form Part 3
No Smoking policy
I ______understand and acknowledge that the entire area of Caulfield Park (including the pavilion/ change rooms, the upstairs social room and the cricket grounds) is a No Smoking Facility.
Signed ______
Registration Form Part 4 – immigration details
Persons WHO REQUIRE VISAS TO ENTER AUSTRALIA are requested to provide the following information.
a) Country of Passport
b) Passport Number
c) Passport Expiry Date
d) Country of Residence
e) Date of Birth
f) Last name as it appears in passport
g) First and middle names (in full)
h) Residential address
i) Gender