Southern Cross Annual 5 Day Poker Run Registration Form
Please DO NOT fill out this form if you are paying by cheque/money order or cash.
Long Sleeve shirts and shirt sizes 4XL and up must be ordered by 30th June.
If not registered before 1st August, a surcharge of $10 will be added to White Class. No meals will be available after 1st August.
Red Class: includes Dinners & B'fasts, T-shirt, Badge & Camping, Poker Hand- $300
Blue Class: includes Dinners, T-shirt, Badge & Camping, Poker Hand- $260
Green Class: includes B'fasts, T-shirt, Badge & Camping, Poker Hand- $220
White Class: includes T-shirt, Badge & Camping, Poker Hand- $150
Long Sleeve Shirt
Direct Debit Only
Southern Cross Association (FTC) Inc.
via NAB, please change ACC No. to 12851420
Date of Deposit
Blue Card (optional) This section is optional. Note: Blue cards are required when giving rides or Marshalling, as per our Duty of Care Procedures.
Blue Card Holder
Willing to give rides at camping grounds / schools
Willing to be a Marshal for rides