Event Registration

Moorambilla Event Payment Form

Name

Please contact Moorambilla’s Lead Ensemble Manager, Lindi Greenfield, if your child name is incorrect in the fields via lindi@moorambilla.com or 0411 391 956.

Email(Required)

Phone(Required)

Not Primary Carer?

Add Primary Carer Email

Primary Carer Email

Child's date of birth(Required)

Event

Total Amount:

Type of Payment

Please select from below

Pay full amount

Pay in 2 fortnightly instalments

Pay in 4 fortnightly instalments

Pay in 7 fortnightly instalments

Amount to pay today

Price:

Pay in 7 fortnightly instalments

Price:

Pay in 4 fortnightly instalments

Price:

Pay in 2 fortnightly instalments

Price:

Credit Card

Card Details

Cardholder Name

Hidden

Start Date

Hidden

End Date

This field is for validation purposes and should be left unchanged.

Moorambilla Event Payment Form

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