Booking Form & T&C's

OUTBACK FAMILY CAMPERS

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Booking Form & T&C's

Booking Form

Outback T&C's

Camper Hire Booking Form

* Indicates required field

1st Day of Hire *

Return Date *

Destination *

Number of Adults *

Number of Children *

Van *

Jayco Starcraft 15ft Jayco Swan Jayco Expanda 17ft Jayco JPod X 1 Jayco JPod X 2

Optional Extras *

Fridge 80ltr Eva Kool Portable Toilet Kayak Generator

How did you hear about us? *

Google Search Facebook Instagram Gumtree Friends/Family Word of Mouth Previous Hire Flyer

Hirer's Details

Name *

First

Last

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Date of Birth *

Driver's Licence Number *

State of Issue *

Expiry *

Email *

Upload Drivers Licence *

Max file size: 20MB

Have you towed a camper van or caravan before? *

Additional Driver Details

Name *

First

Last

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Date of Birth *

Driver's Licence Number *

State of Issue *

Expiry *

Email *

Upload File *

Max file size: 20MB

Have you towed a camper van or caravan before? *

Towing Vehicle Details

Vehicle - Make *

Model *

Year *

Registration Number *

Registration Expiry Date *

Tow ball max down weight *

Do you require a brake controller? *

Yes No

Vehicle towing capacity *

Does your vehicle have an Anderson Plug? *

Yes No

What trailer plug does your vehicle require?

Choose One *

7 Pin Round

Choose One *

7 Pin Round Large

Choose One *

7 Pin Flat

Choose One *

12 Pin Flat

Comprehensive Vehicle Insurance - Company *

Policy Number *

Expiry date of Insurance *

Bank Details for Bond Refund

Name: *

BSB: *

Account No: *

Please tick *

I have read and understand the Terms and Conditions of hire I agree to the Terms and Conditions of hire

**Please make sure all fields with a red * have been filled in before hitting submit, the form will not send if these are not completed**
You will see a confirmation message once it has been successfully submitted.

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Home
Our Vans
Rates & Availability
Booking Form & T&C's
Accessory Hire
Contact Us