CL&AG - Registration Form - Seniors Week 2025 - Pioneer Cemetery

Name*

Phone number*

OPTIONAL QUESTION: Email address

OPTIONAL QUESTION: Are you bringing any guests? Please let us know how many.

OPTIONAL QUESTION: Do you or any of your guests have any dietary preferences we should be aware of?

Photo Consent - I give consent for images to be taken of myself and guests, and for these images to be used, modified, and distributed by the Shire of Carnarvon.*