Tailem Bend Community Centre Inc.

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TBCC Bus Hire Booking Form

TBCC Mini Bus - Online Booking Enquiry Form:

Fill out the form below to submit your booking enquiry.
We will then be in touch with you to confirm your booking and organise payment.

Please be advised - you will receive a confirmation message and email sent to you at the conclusion of completing this form. If you do not receive this confirmation, PLEASE CONTACT TBCC on 08 8572 3513.

Contact Details

Do you hold a Full Licence (not L P1 or P2)*:
YesNo
Licence Number:
Title:
Surname*:
Given Name*:
Middle Name:
Preferred Name:
Date of Birth*:
Gender*:
Street Address*:
Town*:
State*:
Postcode:
Phone*:
Mobile:
Email*:
Country of Birth*:
Main Language*:

Hire Details

Please Note: Off road travel in the TBCC Mini Bus is strictly prohibited.

Pick up Date*:
Pick up Time (am/pm):
Drop off Date*:
Drop off Time (am/pm)*:
Driver Required*:
YesNo
Purpose of Travel*:
Estimated Distance of Travel (km)*:

Towing Weights

Braked (kg):
Unbraked (kg):

Cleaning Fees

Cleaning fees will be determined by TBCC Officer at the time of return (as per General Points 28 & 29 in Terms and Conditions) Excess cleaning fees will apply for such things as vomit, smoking smell, food or drink spills and stains.
I understand

Person / Organisation responsible for payment of hire if not as above

Name:
Address:
Email:
ABN:
Phone:
Are they aware of their obligation to pay:
YesNoNot StatedOther

Payment

Preferred Method of Payment*:
CashDirect DepositCredit CardTBA

Insurance Excess Agreement

I, the "Hirer", confirm that I can read English and accept all the "INSURANCE EXCESS CONDITIONS" set out in this agreement.
I agree

Terms and Conditions Agreement

I, the "Hirer", confirm that I can read English and accept all the "TERMS AND CONDITIONS OF HIRE" set out in this agreement.
I agree

Contact