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.
Registrations after 1st August will default to WHITE CLASS, (no meals) and a $10 surcharge will apply for late resgistration.
Please note, you will not be guaranteed a shirt, and no discounts will be given if there are no shirts available.
White Class: includes Badge & Camping, Poker Hand. Shirt not guaranteed - $180
Direct Deposit 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
Willing to help with meals, bar, activities etc?