Blender Bike Hire Request Form
Contact Information
Organisation/Group
Contact Name/s
Postal Address
Postcode
Contact Number
Email:
example@example.com
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Event/Activity Details
Event Name
Event Location
Event Date and Time
/
Day
/
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Please provide a brief description of what you will be using the blender bike for, i.e. Fundraising for a particular cause
Blender Bike Collection Date
/
Day
/
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Blender Bike Return Date
/
Day
/
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
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Conditions of Use
The
City
of
Armadale
has
made a
blender
bike
available
to
support your
organisation or
community
group
to
encourage healthy fundraising activities. City of Armadale can only keep this service going through your
cooperation in adopting the following conditions of use:
The bike must only be used for its intended purpose as outlined in this
booking form.
The bike or any part of it cannot be lent to a party external to this agreement without expressed permission
from the City of Armadale.
It is the responsibility of the hirer to collect and return the bike to the City of Armadale Ad
ministration Bu
ilding
between the hours of 8:30am and
4.30pm
,
Monday-Friday,
on the dates specified on this
form.
The bike must be stored indoors overnight and not used during wet weather conditions.
The hirer is responsible for the full replacement cost at re
tail pric
e for the bike if it is
lost, stolen or
damaged
beyond repair. The City of Armadale will be notified immediately on the hirer becoming aware of the loss,
damage or theft of the bike.
The Bik
e is not to be used in any way
that misrepresents the City of Ar
madale.
It is the res
ponsibility of the hirer to ensure appropriate cleaning/food safety methods
are applied during use.
The bike and ass
ociated eq
uipment must be returned fully
washed an
d in the same condition it
was in upon
c
ollection.
The hirer is required to
complete the
B
lender
B
ike evaluation form and return it
to the City of Armadale within
seven
(
7
)
days
of
the
return date adv
is
ed on this form.
Submission of this form does not guarantee your booking, and is subject to availability.
Declaration:
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Name
Date
/
Day
/
Month
Year
Date
Signature
Submit
Should be Empty: