Application to use Roseclif Park Equestrian Facility

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone number*
Email*
Intended commencement date*
Date Format: DD slash MM slash YYYY
Intended time of use

: HH

MM
Intended activity*
*
- By submitting this for I agree to:
Use the Roseclif Equestrian Facility in accordance with the Shire of Capel Local Government Property Local Law. Accept responsibility for ensuring compliance with the Shire of Capel Local Government Property Local Law and other written laws relevant to the proposed use. This includes anycondition which may be imposed on the permit requiring me to indemnify the local government in respect of any injury to any person or any damage to any property which may occur inconnection with my use of local government property.
CAPTCHA