ACTIVITY APPLICATION SOUTH ISLAND TOUR 2013 COMMITMENT TO ATTEND

ACTIVITY DETAILS Location: VARIOUS Dates: 11-21 JUL 2013

4SQN 001

Report Date, Time & Location: THU 11/07/13 Jet star Terminal Auckland Airport (Report time TBC) Contact Person & Phone Nos: PLTOFF Mitch Brady 021 024 16624

Pickup Date, Time & Location: SUN 21/07/13 Jet star Terminal Auckland Airport (Pickup time 0740 (07:40am) Cost: $220pp

Cut here - Keep this top section for your own reference Attach payment here and any supporting documentation and return to Admin Office SOUTH ISLAND TOUR 2013 PERSONAL DETAILS Surname: Rank: Address: First Names: Flight: Phone No: AGE: ________ NEXT OF KIN Name: Ph No: CONTACT PERSON FOR DURATION OF ACTIVITY Name: Ph No: Facebook Names to add (include Cadet and/or Parents): Basic / Prof / Adv / NCO / Staff 11-21JUL13

YES Please add me onto the Facebook group so that I can receive instant updates on the planning progress ( )

MEDICAL-IN-CONFIDENCE This data will be compiled at a later date. PARENT /GUARDIAN COMMITMENT I ..........................................................................hereby consent to my son/daughter/ward attending the SI TRIP 2013 detailed above and that he / she can participate in all activities included on the camp.

I understand that I am making a financial commitment to the trip. Completion of this form indicates my commitment and acceptance to go on the Tour. I understand that after a commitment has been made to attend, that if I withdraw, I will still be liable for the cost of the tour ($220) and may not get a refund on any monies paid.
Date: Signature: