LHAC Forum Registration - Young

We are excited to be hosting the next LHAC Forum in Young on Wednesday 16 and Thursday 17 September 2026.

To register for the Forum - please complete the form below - indicating your attendance and preferences.

Personal Details

First Name *

Last Name *

Your position:

LHAC memberMLHD staff memberMPHN staff memberOther

Position - Other: *

LHAC Branch: *

Email Address: *

Phone Number *

Registration

Please indicate which sessions you will be attending *

LHAC Dinner Wednesday 16 September 2026 (5:30pm – 8:30pm)LHAC Breakfast Thursday 17 September 2026 (8:00am – 8:30am)LHAC Forum Thursday 17 September 2026 (8:30am - 3:30pm)

Dietary Requirements / Allergies

Do you have special dietary requirements *

YesNo

What dietary requirements do you have: *

Do you have any other allergies we need to be aware of?

Accessibility

As your hosts, Young LHAC are here to help! Please let us know how we can assist you

Directions for ramp accessAssistance at meal breaks (making a cuppa, carrying plate for you)Other

Please provide details, or request a callback and we will phone you for a confidential chat *

Travel

Do you require support to travel to/from Young? For example, carpooling with other LHAC members or facility staff *

Yes No

For example, carpooling with other LHAC members or facility staff

What support is required? *

Accommodation

We will book and pay for your accommodation in Young for the evening of Wednesday 16 September 2026.

Please indicate if you require accommodation preference: *

Accommodation not requiredSingle Room Twin Share room Double RoomOther

Accommodation - Other *

IF SHARING ROOM: please advise who you will be sharing with

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