MEMBER REGISTRATION FORM Name(Required) First Last Position(Required) Council(Required)Albury City CouncilArmidale Regional CouncilBallina Shire CouncilBalranald Shire CouncilBathurst Regional CouncilBega Valley Shire CouncilBellingen Shire CouncilBerrigan Shire CouncilBland Shire CouncilBlayney Shire CouncilBogan Shire CouncilBourke Shire CouncilBrewarrina Shire CouncilBroken Hill City CouncilByron Shire CouncilCabonne CouncilCampbelltown City CouncilCanterbury Bankstown CouncilCarrathool Shire CouncilCastlereagh-Macquarie County CouncilCentral Coast CouncilCentral Darling Shire CouncilCentral Murray County CouncilCentral Tablelands CountyCessnock City CouncilCity of Canada Bay CouncilCity of NewcastleCity of RydeClarence Valley CouncilCobar Shire CouncilCobar Water BoardCoffs Harbour City CouncilCoolamon Shire CouncilCoonamble Shire CouncilCootamundra Gundagai Regional CouncilCowra Shire CouncilDungog Shire CouncilEdwards River CouncilEurobodalla Shire CouncilFairfield City CouncilFederation CouncilForbes Shire CouncilGeorges River CouncilGilgandra ShireGlen Innes Severn CouncilGoldenfields Water County CouncilGoulburn Mulwaree CouncilGreater Hume Shire CouncilGriffith City CouncilGwydir Shire CouncilHawkesbury River County CouncilHay Shire CouncilHilltops CouncilHornsby Shire CouncilInner West CouncilInverell Shire CouncilJunee Shire CouncilKempsey Shire CouncilKu-ring-gai CouncilKyogle CouncilLachlan Shire CouncilLake Macquarie City CouncilLeeton Shire CouncilLismore City CouncilLithgow City CouncilLiverpool Plains Shire CouncilLockhart Shire CouncilMaitland City CouncilMid Coast CouncilMoree Plains Shire CouncilMosman Municipal CouncilMurray River CouncilMurrumbidgee CouncilMuswellbrook Shire CouncilNambucca Valley CouncilNarrabri Shire CouncilNarrandera Shire CouncilNarromine Shire CouncilNew England TablelandsNorfolk Island Regional CouncilNorth Sydney CouncilNorthern Beaches CouncilOberon CouncilPort Macquarie-Hastings CouncilPort Stephens CouncilQueanbeyan Palerang CouncilRandwick City CouncilRiverina Water County CouncilRous County CouncilShoalhaven City CouncilSingleton CouncilSnowy Valleys CouncilStrathfield CouncilSutherland Shire CouncilTamworth Regional CouncilTemora Shire CouncilTenterfield Shire CouncilThe Hills Shire CouncilTweed Shire CouncilUpper Hunter County CouncilUpper Hunter Shire CouncilUpper Lachlan Shire CouncilUpper Macquarie County CouncilUralla Shire CouncilWagga Wagga City CouncilWalcha CouncilWalgett Shire CouncilWarren Shire CouncilWarrumbungle Shire CouncilWaverley CouncilWeddin CouncilWentworth Shire CouncilWingecarribee Shire CouncilWollondilly Shire CouncilWoollahra Municipal CouncilYass Valley CouncilEmail(Required) Phone(Required) CONFERENCEWill you be attending both days of the conference?(Required)YesNoThursday 24th and Friday 25th August 2023If not, which day will you be attending?(Required)Thursday OnlyFriday OnlyWORKSHOPSPlease indicate which Workshop you would like to attend on Day 1, Thursday 24th August:(Required) WORKSHOP 1: Waste Management WORKSHOP 2: People Risk Waste Management: Session 1 Waste management is providing challenges to our sector. Two member councils will speak on their experiences in waste management. People Risk: Session 2 Marsh Mercer Benefits will inform on the current challenges and solutions relating to managing “People risks”. They will provide examples of their work with a member council.Please indicate which Workshop you would like to attend on Day 2, Friday 25th August:(Required) WORKSHOP 3: Claims Management WORKSHOP 4: Asset Management Claims Management: Session 3 JLT Claims Manager, Gareth Edwards will host a workshop on current topical claims matters. Asset Management: Session 4 AVCRM The use of RPA’s is improving efficiency and effectiveness in managing built assets and infrastructure. AVCRM will demonstrate their experience in this space with a member Council. IamOmni A member Council has partnered with IamOmni to electronically assist with managing and recording the risk mitigation of their assets. IamOmni will demonstrate their outcomes for the member council. GENERAL MANAGERS FORUMAre you a General Manager?(Required)YesNoIf yes, would you like to attend the General Managers Luncheon?(Required)YesNoDINNERWill you be attending the Conference Dinner?(Required)YesNoHeld on Thursday 24th August at The Sofitel WentworthPRE CONFERENCE EVENTWe will be hosting pre-conference drinks and canapes on the 23rd August, will you be attending?(Required)YesNoTime 5:00pm - 8:00pm. Venue TBA. More details coming soon.DIETARY REQUIREMENTSDo you have any dietary requirements?(Required)None at allGluten FreeVegetarianVeganOtherThis will be factored for both the conference catering and the dinner catering.Please outline any other dietary requirements you have and we will endeavour to address these.(Required) PAYMENT TERMS & CONDITIONSAs a Member, your conference registration and dinner costs are covered by the Mutual. However, if cancellation notice is not received by Monday 14th August 2023, or you do not show up, you will be invoiced the full amount of $660 (inc GST) for the 2 day conference and $220 (inc GST) for the dinner.(Required) I have read and agree to the Payment Terms & Conditions