Speed Dating Brisbane Register

To register your interest in an upcoming Brisbane Speed Dating event, please fill out your details below and click on the submit button.

**With Location you can select more than one** We will be having events in the Gold Coast & Sunshine Coast soon. As we have Brisbane events alot more frequently, we advise that you also select this if you are not too far from the Brisbane CBD area.

From here you will receive weekly emails from us with details of suitable upcoming events.

All fields marked * are required.

**With Location you can select more than one**

*Gender	male female
*First Name
*Surname
*Location Brisbane Gold Coast Sunshine Coast
*Date of Birth (DD/MM/YYYY)	/ /
*Contact Phone Number
*Mobile
*Email address
Occupation
How did you find us?	been before
	friend/family
	Internet search
	flyer
	advertising
	radio
	mobile billboard
	newspaper
	poster
	I would like to receive Brisbane Speed Dating specials and upcoming events

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