Hui Taumata 40th Anniversary: Registration Form
"Te Kukuwhata: Evolution"
16th to 18th November 2023

Instructions
Tēnā koe
Please complete all sections of this registration form, one form per person. Submitting an incomplete form may delay processing of your registration.

Question Title

* 1. Name and Contact Details

Title (Mr, Ms, Miss, Mrs) *

Name *

Preferred Name (for Conference ID) *

Mobile Ph. *

Home Ph.

Email *

Question Title

* 2. Organisation Details

Organisation Name

Your Title

Work Mobile Ph.

Work Ph.

Website address

Facebook address

Emergency Contact

In the event of an emergency who would you like us to contact? Please provide the names of two people.

Question Title

* 3. Contact Person

Name *

Relationship to you *

Email *

Mobile Ph. *

Home Ph.

KMA Tangata (Financial) Member Subscription

If you are 18 years or older you can register as a KMA Tangata (financial) member.
2022 and 2023 subscription $40.00 (GST Incl.)

Question Title

* 4. Are you a current ‘financial’ KMA Tangata member?

Yes

Not sure if my membership subscription is current. KMA, can you email or phone me please.

Question Title

* 5. Would you like to register as a KMA Tangata (financial) member?

Yes

No, but I would like to give a ‘koha’

Delegate Registration Packages

Using hotel room telephone: Your conference registration does not include this cost so you will be asked to pay this expense on checkout.
Hotel mini bar: Your conference registration does not include this cost so you will be asked to pay this expense on check-out.
Charging back to your room: Your conference registration does not include expenses you charge back to your room. You will be asked to pay all expenses charged back to your room on check-out.

Requests to book accommodation before and after KMA Biennial Conference

Yes, you can book accommodation before 16th November or after 18th November.

Requests to purchase additional 18th November 2023 Hākari tickets

Yes, you can purchase additional tickets. Note. There is a limit so early purchase is recommended.

1. KMA Tangata (Financial) Member Delegate Registration Options

1a) Full Package (1 delegate): Price $810 includes:
· 3 nights’ accommodation : (16th to 18th November)
· Breakfast (cooked) : (17th, 18th and 19th November)
· Morning tea : (17th and 18th November)
· Lunch: (16th, 17th and 18th November)
· Afternoon tea : (16th, 17th and 18th November)
· Dinner : (16th and 17th November)
· 40th Anniversary Hākaari : (18th November)
· On-site program activities.
· 1 Commemorative T-shirt or polo shirt.
1b) Full Package (A maximum of 2 delegates): Price $610 each includes:
· 3 nights’ accommodation (twin share): (16th to 18th November)
· Breakfast (cooked) : (17th, 18th and 19th November)
· Morning tea : (17th and 18th November)
· Lunch: (16th, 17th and 18th November)
· Afternoon tea : (16th, 17th and 18th November)
· Dinner : (16th and 17th November)
· 40th Anniversary Hākaari : (18th November)
· On-site program activities.
· 1 Commemorative T-shirt or polo shirt per person
1c) Day Registration: Price $210 per day includes:
· Morning and afternoon tea
· Lunch
· Dinner (16th and 17th November 2023)
1d) 18th November 2023 Hākari ticket price: $120 per person

A. KMA Tangata (Financial) Member Delegate Registration
Choose your 'Full package' or 'Day Registration' option

Question Title

* 6. Full package:

$810 – 1 delegage

$610 each – 2 delegates

Question Title

* 7. Day Registration: $210 per day

1 day

2 days

3 days

Question Title

* 8. KMA Commemorative T-shirt(s) or Polo Shirt(s): KMA Tangata (Financial) Members Only

T-shirt or

Polo shirt

Colour: White or

Colour: Black or

Colour: Blue

Please specify size e.g. small, medium, large XL, 2XL-5XL:

Question Title

* 9. Additional requests

Yes, I would like to book additional accommodation

Yes, I would like to book a cot

Yes, I would like to charge expenses back to my room

Yes, I would like to purchase 18th November 2023 Hākari ticket(s)

Yes, I would like a Tax Invoice

Please specify: a) additional accommodation date(s) and/or b) number of 18th November 2023 Hākari tickets you would like to purchase

2. All Other Delegates' Registration Options

2a) Full Package (1 delegate): Price $920 includes:
· 3 nights’ accommodation : (16th to 18th November)
· Breakfast (cooked) : (17th, 18th and 19th November)
· Morning tea : (17th and 18th November)
· Lunch: (16th, 17th and 18th November)
· Afternoon tea : (16th, 17th and 18th November)
· Dinner : (16th and 17th November)
· 40th Anniversary Hākaari : (18th November)
· On-site program activities.
2b) Full Package (A maximum of 2 delegates): Price $720 each includes:
· 3 nights’ accommodation : (16th to 18th November)
· Breakfast (cooked) : (17th, 18th and 19th November)
· Morning tea : (17th and 18th November)
· Lunch: (16th, 17th and 18th November)
· Afternoon tea : (16th, 17th and 18th November)
· Dinner : (16th and 17th November)
· 40th Anniversary Hākaari : (18th November)
· On-site program activities.
2c) Day Registration: Price $310 includes:
· Morning and afternoon tea
· Lunch
· Dinner (16th and 17th November 2023)
2d) 18th November 2023 Hākari ticket price: $120 per person

B. All Other Delegates' Registration
Choose your 'Full package' or 'Day Registration' option

Question Title

* 10. Full package:

$920 – 1 delegate

$720 each – 2 delegates

Question Title

* 11. Day Registration: $310 per day

1 day

2 days

3 days

Question Title

* 12. All other Kāpō Māori Aotearoa Commemorative T-shirt(s) or Polo Shirt(s) Orders

T-shirt or

Polo shirt

Colour: White or

Colour: Black or

Colour: Blue

Please specify size e.g. small, medium, large, XL, 2XL-5XL:

Question Title

* 13. Additional Requests

Yes, I would like to book additional accommodation

Yes, I would like to purchase 18th November 2023 Hākari ticket(s)

Yes, I would like to book a cot

Yes, I would like to charge expenses back to my room

Yes, I would like a Tax Invoice

Please specify a) additional accommodation date(s) and/or b) number of 18th November 2023 Hākari tickets you would like to purchase

Payment Options

A. Kāpō Māori Aotearoa Tangata (Financial) Members Only

Can choose how to pay Kāpō Māori Aotearoa Tangata (financial) member subscription, delegate registration, cot hire, additional accommodation and Hākari tickets. Either:

a) By ‘Payless Payment’: weekly, fortnightly or monthly instalments; or
b) Lump sum payment.

Full payment is due by 5pm, Friday, 29th September 2023.

B. All Other Delegates

Full payment of delegate registration, cot hire, additional accommodation and Hākari tickets is due by 5pm, Friday, 29th September 2023.

KMA Bank Account Details

Bank and branch: ANZ, Hastings CBD
Account Name: Ngāti Kāpō Aotearoa Inc.
Account Number: 06-0645-00420934-22
Reference: HT2023 - Initial of first name and last name in full e.g. HT2023MCage

Conference Requirements

Please complete all sections:

Accessible Formats & Communications

Question Title

* 14. What is your format preference? (Please choose one of the following options. Tangata (financial) members’ and ‘Other delegates’ who do not answer this question will be issued ‘Large Print’ conference documents)

Large print

Audio

Braille

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* 15. How would you like your conference information sent to you? (Please choose one of the following options. 'Tangata (financial members' and 'Other delegates' who do not answer this question will be sent their conference documents by email in pdf. format)

Email (Word format)

Email (pdf.)

Courier Post

Tāngata Whaikaha

Question Title

* 16. I am and or have a (Please choose from the following and or add under ‘Other’)

Blind

Low Vision

Deafblind

Deaf

Hearing impaired

Physical disability (Please specify in 'Other')

Other (please specify)

Mobility

Question Title

* 17. I use and or require a (Please choose from the following and or add under ‘Other’)

Wheelchair

Walking frame

Walking stick

White cane

Guide dog

Support dog

Sighted guide

NZSL trilingual interpreter

Hearing aids

Hearing loop

Carer

Other (please specify)

Medical Conditions

Question Title

* 18. I have the following medical conditions. (Please choose from the following and or add under ‘Other’)

Diabetes (Please specify which type in 'Other')

Epilepsy

Heart condition (Please specify in 'Other')

Brain injury

Allergies (Please specify in 'Other')

Other (please specify)

Dietary Requirements

Question Title

* 19. I have specific dietary requirements (medical, religious, personal preference)? (Please choose from the following and or add an explanation)

Vegetarian

Diabetic

Gluten Free

Medical

Religious

Other

Please specify medical, religious and other dietary requirements

If you have any questions or would like assistance contact Kāpō Māori Aoteaora:

Free phone: Ph. 0800 770 990
Email: info@kapomaori.com
Facebook: https://www.facebook.com/KapoMaoriAotearoaNZ/
Website: https://www.kapomaori.com
National Office Postal Address: PO Box 933, Hastings 4122

Thank you for completing your registration. We look forward to hosting you at Kāpō Māori Aotearoa Hui Taumata 40th Anniversary 2023.

Hui Taumata 40th Anniversary: Registration Form"Te Kukuwhata: Evolution"16th to 18th November 2023

Question Title

* 1. Name and Contact Details

Question Title

* 2. Organisation Details

Question Title

* 3. Contact Person

Question Title

* 4. Are you a current ‘financial’ KMA Tangata member?

Question Title

* 5. Would you like to register as a KMA Tangata (financial) member?

Question Title

* 6. Full package:

Question Title

* 7. Day Registration: $210 per day

Question Title

* 8. KMA Commemorative T-shirt(s) or Polo Shirt(s): KMA Tangata (Financial) Members Only

Question Title

* 9. Additional requests

Question Title

* 10. Full package:

Question Title

* 11. Day Registration: $310 per day

Question Title

* 12. All other Kāpō Māori Aotearoa Commemorative T-shirt(s) or Polo Shirt(s) Orders

Question Title

* 13. Additional Requests

Question Title

* 14. What is your format preference? (Please choose one of the following options. Tangata (financial) members’ and ‘Other delegates’ who do not answer this question will be issued ‘Large Print’ conference documents)

Question Title

* 15. How would you like your conference information sent to you? (Please choose one of the following options. 'Tangata (financial members' and 'Other delegates' who do not answer this question will be sent their conference documents by email in pdf. format)

Question Title

* 16. I am and or have a (Please choose from the following and or add under ‘Other’)

Question Title

* 17. I use and or require a (Please choose from the following and or add under ‘Other’)

Question Title

* 18. I have the following medical conditions. (Please choose from the following and or add under ‘Other’)

Question Title

* 19. I have specific dietary requirements (medical, religious, personal preference)? (Please choose from the following and or add an explanation)

Hui Taumata 40th Anniversary: Registration Form
"Te Kukuwhata: Evolution"
16th to 18th November 2023