Name *

First Name

Last Name

Central South Regional Hui days attending

Please indicate which days

Day One - Monday 23 March 2020

Day Two - Tuesday 24 March 2020

Day Three - Wednesday 25 March 2020

Central South Regional Hui Airport pick up

Please indicate if you will be picked up from the airport at 1 pm on Monday 23 March 2020.

Yes

No

Midlands Regional Hui days attending

Please indicate which days

Day One - Monday 30 March 2020

Day Two - Tuesday 31 March 2020

Day Three - Wednesday 1 April 2020

Midlands Regional Hui Waahi Pa Marae Stay *

Please indicate if you are staying at Waipatu Marae

Yes

No