Hire Agreement

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Fields marked with * are required.

Hirers personal details

Full Name

Address:

No.

Street

Suburb

State

Postcode

License Number

License expiry date

Phone (Home)

Phone (Mobile)

Email to send confirmation to

Towing Vehicle Details

Vehicle Make

Model / Year

Colour

Type of trailor connection (E.g. 7 Pin round)

Registration Number

Registered Owner

Pick Up Date (Hire date)

Pick Up Time

Return Date (Hire end date)

Return Time

Proposed Destination

Payment Via Direct Credit

Account Name

CAMP EZY CAMPER TRAILER HIRE

Bank

WESTPAC

BSB

034239

Account Number

294376

Deposit (Req to guarantee hire) $

Security Bond (Due min 14 days prior to hire.
Refundable within 7 business days Terms) $

Full hire fee (Due minimum 14 days prior to hire) $

Total $

4kg Gas Bottle Hire ($22 Each)

Transfer Receipt Number

Date of Transfer

Hirer's bank account details (for return of bond via direct deposit)

Account name

Bank

BSB

Account No.

Phone No.

I accept the Terms & Conditions. *

Please enter the following security code:

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