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.
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Meals, long sleeve and polo shirts and sizes 6XL and 7XL must be ordered and paid for by 31 July. If you order after this date we cannot guarantee you a shirt in your size. 
 
Class *
Long Sleeve Shirt *
Shirt Size *
Payment: Direct Debit Only. Acc Name: Southern Cross Association (FTC) Inc.
Bank: Bendigo BSB: 633000 Acc No.: 128514205 Your Ref: Initial.SurnamePR22
 
Payment Options *
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Current Total:
$0.00
This section is optional. Note: Blue cards are required when giving rides or marshalling with children.
Are you able to help with cards, meal sheets etc at the campsites?
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