Program Registration

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Program Registration

Program Registration

PARTICIPANT DETAILS
First Name*
Surname*
Position*
Department
Organisation/Company*
Mailing Address*
Work Phone
Mobile*
Email*
Dietary Requirements:*
Medical:*
(Please indicate if any conditions we should be made aware of eg. Bad back, asthma etc
Specific facilities
If you need any other specific facilities (wheelchair access etc) please advise
Emergency contact name*
Phone*
Participant Signature*
Date*
DD slash MM slash YYYY
NOMINATED BY
Please advise who nominated you for the program
First Name
Surname
Organisation/Company
Position
Email
2025 PROGRAMS
Please select program you wish to register for. Please note that Self Leadership program runs in 2 parts.
Product Name*
Price Including GST
Payment Method
Invoice Address*
Please Send Invoice to the following address (select one)
- Same as mailing address
- New Invoice Address
Organisation/Company*
Name
First Last
Address
Street Address City State / Province / Region ZIP / Postal Code
Email*
Total
$ 0.00
Price Includes GST

TERMS & CONDITIONS

The following terms and conditions apply to all programs delivered by Creating Breakthroughs (CB).

Program:

CB reserves the right to change the program dates at any time. Every effort will be made to ensure an equivalent event is made available.

Registration and Payment:

Payment in full is required by the program date in order to attend.

Substitutions:

If you are unable to attend a program, a replacement delegate may be sent in your place at no extra charge. It is the participant’s responsibility (or their Manager) to advise of this change. Notification must be made in writing within 7 days and received prior to the program commencing by emailing support@c-b.com.au.

Cancellation Policy:

Cancellations must be received in writing to support@c-b.com.au no later than three (3) weeks prior to the program date. No refunds will be given after this date. Cancellations made prior to three (3) weeks will receive a full refund.

Privacy Notice:

CB is concerned with the protection of your privacy. We support the privacy principles contained in the Privacy Act 1988 (Cth), as amended. CB collects and stores your personal information for the purposes of promoting products and services in the form of email communications and/or other types of communication. Email support@c-b.com.au if you would prefer not to receive communications from CB. Credit card payments are made directly through ANZ Online to ensure your personal details are kept safe. None of your payment details are stored by CB.

Image Release:

In registering for CB programs, you grant permission to CB to take and to have full and free use of video/photographs containing your image/likeness. It is understood these images may be used for promotional, news, online/multimedia, and/or educational purposes by and for CB. You agree that you are not entitled to remuneration, residuals, royalties or any other payment from CB in respect of your image/likeness or its use. You release, discharge, and hold harmless, CB from any and all claims, demands or causes of actions that you may hereafter have by reason of anything contained in the photographs or video. Should you not agree to the above image release, you must advise CB by email at support@c-b.com.au.

Program Registration