* First Name:

Last Name:

Gender:

M F

Date Of Birth (dd/mm):

/ / (year may be blank)

* Mobile No:

Street Address:

Suburb/Town/City:

Postcode:

Country:

State / Province / Region:

* Email:



* Are you a:
* When was your last visit to Luna Park:
* Do you have children:
Yes No
If so we'd like to send them special birthday offers:
Child 1
Name: DOB: (dd/mm/yyyy) Pick Date
Child 2
Name: DOB: (dd/mm/yyyy) Pick Date
Child 3
Name: DOB: (dd/mm/yyyy) Pick Date
Child 4
Name: DOB: (dd/mm/yyyy) Pick Date
Child 5
Name: DOB: (dd/mm/yyyy) Pick Date
 
* When I come to Luna Park, I come:
By myself
With a group of friends
With my partner
With my family
Other
Other:
* Please notify me regarding:
Special Offers & Competitions School Holiday Information
Special Events General Functions
Corporate Functions Last Minute Deals
New Attractions  
Any comments?
 

Luna Park does not disclose any personal contact information provided on this form for use by a third party, in compliance with the National Privacy Act and relevant Anti Spam Act.