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The Addi and Cassi Fund - Niemann Pick Type C

Treatments & Cures for Niemann Pick Type C – Childhood Alzheimer's

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You are here: Home / 2012 Aussie Golf Experience Planning Form

2012 Aussie Golf Experience Planning Form

Your Contact Info
Name*
FirstLast
Email*
Phone*
cell phone is best...
Handicap
Melbourne Arrival Information
- I prefer to make my own Airport -> Hotel transfer arrangements
- I would like to get picked up if possible
Arrival Airline*
Flight Number*
Arrival Date*
Arrival Time*
: HH
MM
Melbourne Departure Information
- I prefer to make my own Hotel -> Airport transfer arrangements
- I would like to get taken to the airport if possible
Departure Airline*
Departing Flight Number*
Departure Date*
Departure Time*
: HH
MM
Emergency Contact Info
Emergency Contact Name*
FirstLast
Emergency Contact Phone*
Emergency Contact Email*
Transportation Preferences*
- I must have my own car
- I am happy to "carpool"
- I only travel in huge limosines
Do You have Dietary Restrictions?*
- Yes
- None
Please describe your dietary needs here...
Personal Residences or Hotel?*
- Hotels Only Please
- I am open to both
- I prefer Personal Residences
Accomodations*
- I positively need my own private hotel room
- I prefer my own private room but I can bunk up if needed
- I prefer to bunk up!
Please choose your TOP 3 Restaurant Preferences*
- French
- Italian
- Thai or other Asian
- Seafood
- Chinese
- Steakhouse
Please use this area to make comments, suggestions or requests.

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