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.
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