Event Registration

Please use the form below to register for events organised by Western Queensland Primary Health Network

All fields marked with an asterisk (*) are required.

If the event you wish to register for is not in menu below, please register by downloading the flyer from the event page.  

View All Upcoming Events

Please select the event you wish to register for: (required)

Name*:

Email*:

Organisation*:

Profession*:

Phone*:

Receive SMS Reminder?:

SMS Mobile Number:

Dietry Requirements:

Add a guest? (up to 5 guests):

Guest One

Guest 1 Name:

Guest 1 Email:

Guest 1 Organisation:

Guest 1 Profession:

Guest 1 Phone:

Receive SMS Reminder?:

Guest 1 SMS Mobile Number:

Guest 1 Dietary Requirements :

Add a second guest? (up to 5 guests):

Guest Two

Guest 2 Name:

Guest 2 Email:

Guest 2 Organisation:

Guest 2 Profession:

Guest 2 Phone:

Receive SMS Reminder?:

Guest 2 SMS Mobile Number:

Guest 2 Dietary Requirements:

Add a third guest? (up to 5 guests):

Guest Three

Guest 3 Name:

Guest 3 Email:

Guest 3 Organisation:

Guest 3 Profession:

Guest 3 Phone:

Receive SMS Reminder?:

Guest 3 SMS Mobile Number:

Guest 3 Dietary Requirements:

Add a fourth guest? (up to 5 guests):

Guest Four

Guest 4 Name:

Guest 4 Email:

Guest 4 Organisation:

Guest 4 Profession:

Guest 4 Phone:

Receive SMS Reminder?:

Guest 4 SMS Mobile Number:

Guest 4 Dietary Requirements:

Add a fifth guest? (up to 5 guests):

Guest Five

Guest 5 Name:

Guest 5 Email:

Guest 5 Organisation:

Guest 5 Profession:

Guest 5 Phone:

Receive SMS Reminder?:

Guest 5 SMS Mobile Number:

Guest 5 Dietary Requirements:

Note! Please double-check that all of your details are correct before submitting.