To register for the Charity Gala, please fill in the form below.

Brainwave Australia as Trustee for the Brainwave Trust
National: 1300 766 819
© 2010

RSVP

Friday 15 July, 2011

Download a Booking Form

If you would prefer to confirm your booking via fax, click here to download a PDF form that you can fax back to (02) 9285 0561 or mail it to:

Brainwave Australia
PO BOX 687
Port Melbourne VIC 3207

Alternatively, call 1300 766 819 to register your attendance to the Brainwave Charity Gala.