Nexus 2025 event registration

I will be registering as *

Select your Category *

Select your State *

First Name *

Last Name *

Preferred Email *

As all future communication and emails will be sent to this address, be sure to check that it is correct. The automated confirmation email will only go to this email address.

Mobile Phone Number *

Please write this in the following format xxxx xxx xxx. E.g. 0404 121 114

Gender *

Registration Category (Spouse) *

Select your State (Spouse) *

First Name (Spouse) *

Last Name (Spouse) *

Email (Spouse) *

As all future communication and emails will be sent to this address, be sure to check that it is correct.

Mobile Phone Number (Spouse) *

Please write this in the following format xxxx xxx xxx. E.g. 0404 121 114

How many children are in this registration? *

Child 1 - Name *

Child 1 - Age in January 2025 *

Child 2 - Name

Child 2 - Age in January 2025

Child 3 - Name

Child 3 - Age in January 2025

Child 4 - Name

Child 4 - Age in January 2025

Child 5 - Name

Child 5 - Age in January 2025

Kid's Programme Acknowledgement *

I acknowledge that I will complete a Kids Registration Form for each child attending conference.

Each child needs an individual registration for them for Kid's Programme purposes. There will be a link to this form under the childcare tab on the conference website, as well as linked in the confirmation email. These are due Nov 30th.

Do you require linen? *

Linen is $44/ set and includes sheets, pillow and pillow case, blanket and towel. Unless informed otherwise all beds are singles so a set of linen is needed for each person.

Roommate Preference

Please list anyone with whom you would like to share a room with. Every effort will be made to put you with at least one of these people. If you need a quiet room, please indicate as well with the reason.

How many coffee tokens for the Camp Grounds Cafe would you like?

Mid programme we will be having a fun activities time that the adults can do while the children are still in childcare. Our hope is that we can have some good quality time together in a social atmosphere to connect with one another.

Fun Activity Choice *

As some of these activities need pre booking, if you change your mind please let us know before registration closes. More information on the activities can be found on the website. As some activities have discounts for group bookings or have minimum number requirements, the cost of activities with a fee will be charged after conference. Campus National is covering some of the costs associated with these activities.

Fun Activity Choice (Spouse) *

As some of these activities need pre booking, if you change your mind please let us know before registration closes. More information on the activities can be found on the website. As some activities have discounts for group bookings or have minimum number requirements, the cost of activities with a fee will be charged after conference. Campus National is covering some of the costs associated with these activities.

Does anyone in this registration have any dietary requirements?

Please write the name only of the person/s that have dietary needs. An email from smtp@qccc.org.au will be sent to each person (or the parent of the child) that has dietary needs, so that you can fill in the specific details that then go straight to the venue. Please do this before the 1st January.

Does anyone in this registration have any medical conditions?

Please write the name only of the person/s that have medical conditions. An email from smtp@qccc.org.au will be sent to each person (or to the parent if it is a child) that has medical conditions, so that they can fill in the specific details that then go straight to the venue. Please do this before the 1st January.

Do you (or, if applicable, your spouse) have a First Aid Qualification which will be current until the end of conference?

Please write the name of the person/s with the valid first aid certificate.

Do you (or, if applicable, your spouse) have a Bronze Medallion or similar qualification which will be current until the end of conference?

Please write the name of the person/s with the valid Bronze Medallion or similar qualification information.

Transport to Conference *

Number of Passengers (To) *

Number of Passengers to Conference (Bus) *

Including kids who won't sit on parent's laps (1 years and above)

Transport From Conference *

Number of Passengers (From) *

Number of Passengers from Conference (Bus) *

Including kids who won't sit on parent's laps (1 years and above)

Would you like us to use the emergency contact from your annual submission? *

For non-Australian missionaries please select No.

Please give the details of someone we can contact for you (or your spouse/family) in the event of an emergency. The person must be 18 years or older and is not attending conference. It is ok if they do not live in Australia.

Name *

This cannot be someone at conference. It is ok if this person is overseas.

Relationship to you *

Contact Phone Number *

Alternate Phone Number

I understand that photographs and video taken at conference may be used by Power to Change in promotional materials (online or print). *

Privacy Statement *

©Power to Change ABN 25126098398 is an international faith based mission that connects people to Jesus and each other. We respect your privacy and will only use your information to do what you have asked (eg. registration / donation / subscription) and to keep you informed of our work. We will not pass your details onto unrelated third parties and we will allow you to opt out of our publications. See our Privacy Policy at www.powertochange.org.au

Please tick the box above to accept these terms and conditions.

Can you think of any additional info that might be helpful for the Conference organisers to know about your registration?

I will be paying via *

Please take the amount from my support account

For Australian participants only. You will be emailed the details.

Ministry Account Number

If you are NOT paying from your personal ministry account please write in the details here, otherwise please leave blank

Amount

Payment Method *

Select a payment option above Or pay by Credit Card

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Type*

Card Holder Name*

*

Verification code*

Registration

Fun Activity

Dietary Requirements & Medical Information

Transport

Emergency Contact

Photography Notice

Payment Information

Payment Information