PLEASE COMPLETE THIS FORM AND FAX BACK TO SOUTHERN HEMISPHERE BY 6 July 2016 ON FAX NO: +27 (0) 21424 7965 or email

Please specify how you heard about the event: / Email / Fax / Web: / Word of mouth / Terms and Conditions (Please read carefully)
1. FEES are inclusive of refreshments, luncheons, programme materials and certificate.
ORGANISATION DETAILS
Participant name MUST appear as you wish to see it on the course certificate!! / 2. Payment Terms: A non – refundable deposit of 50% of the full workshop fee is to accompany registration. No registration can be confirmed until Southern Hemisphere receives a faxed copy of payment & a signed registration form by 6 July 2016.
Title & Name: / 3. We reserve the right to refuse admission if payment is not received on time. Unless otherwise stated, payment must be made in SA Rand.
Organisation and Country: / 4. Cancellation / Substitution: provided the total fee has been paid, substitutions, at no extra charge, up to 14 days before the event are allowed. Otherwise all bookings carry a 50% cancellation liability immediately after this signed sales contract has been received by Southern Hemisphere.
Position: / Cancellations must be received in writing by mail or fax one (1) week after registering for the event, in order to obtain a full credit for any future similar event. Thereafter, the full event fee is payable and is non refundable. Non-payment or non-attendance does not constitute cancellation.
VAT #: / By signing this contract, the client agrees that in case of dispute or cancellation of this contract that Southern Hemisphere will not be able to mitigate its losses for any less than 50% of the total contract value.
Tel: / If, for any reason, Southern Hemisphere decides to cancel or postpone this event, is not responsible for covering airfare, hotel, or other travel costs incurred by clients. The event fee will not be refunded, but can be credited to a future event.
Cell: / 5. Copyright, etc: All intellectual property rights in all materials produced or distributed in connection with this event is expressly reserved and any unauthorized duplication, publication or distribution is prohibited.
Email: / 6. Important note: While every reasonable effort will be made to adhere to the advertised package, Southern Hemisphere reserves the right to change event dates, sites or location or omit event features, as it deems necessary without penalty and in such situations no refunds, part refunds or alternative offers shall be made.
State any food preferences: / Halaal / Kosher / Vegetarian / NONE / In the event that Southern Hemisphere permanently cancels the event for any reason whatsoever, (including, but not limited to any force majeure occurrence) and provided that the event is not postponed to a later date, the Client shall receive a credit note for the amount that the Client has paid to such permanently cancelled event, valid for up to one year to be used at another event. No refunds, part refunds or alternative offers shall be made.
7. Event programme content is subject to change without notice.
WORKSHOP FEES
R 6,700.00 (excl. VAT) per delegate. Fees include refreshments, luncheons & programme materials & certificate.
R 7,638.00 (incl. VAT) per delegate. 10% discount per delegate if an organisation sends 3 or more delegates.
Early bird discount: full payment by 10 June 2016 and receive a 10% discount. / ·  Do you have any disabilities? yes or no? If yes, please describe: ......
AUTHORISATION
METHOD & TERMS OF PAYMENT / Signatory must be authorised to sign on behalf of the contracting organisation.
Please indicate your payment method: / By signing, I fully understand and agree with the terms and conditions as set out above, and realise that this is document constitutes a legally binding sales contract.
Bank transfer: / Open Space Consultants cc, T/A Southern Hemisphere, The Standard Bank of South Africa, Plein Street, Cape Town branch, Account No: 070498288, B/C: 020009 Cheque a/c. Swift code: SBZAZAJJ. / Signed at / this the / day of / 2016.
Cheque: / Made payable to: Southern Hemisphere cc / FOR DELEGATE / FOR Southern Hemisphere
FAX PROOF OF PAYMENT TO +27 (0) 21 4247965 or email / Signature: / Signature:
Terms: / Name: / Name:
Full payment together with a proof of payment, TO ACCOMPANY THIS SIGNED REGISTRATION FORM. or Government order number by 6 July 2016. / Date: /
dd / mm / yy
/ Date: /
dd / mm / y y
Witness: / / Witness: /
THIS BOOKING IS INVALID WITHOUT A SIGNATURE
If you do not receive a confirmation letter, outlining your participation details by 18 July 2016, please contact Pippa on tel: +27 (0) 21 422 0205 or email