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.
Meals, long sleeve 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.SurnamePR24
Payment Options *
Current Total:
Are you able to help with cards, meal sheets etc at the campsites?
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