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Beach Walker Hire Form

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Application for free hire of Beach Walker

All fields are required except where indicated
 

Name of Hirer

Support Persons details

Does 'the user' require a support person to operate the beach walker:
Please note: If ‘the user’ is not confident and is at risk of falling whilst using the equipment, a support person will be required to assist whilst using the beach walker.

Name of User

 

Available during office hours Monday - Friday, 8.30 am to 16.30. Sat and Sunday 10.00 am to 14.00hrs

Time hire beginning at (2 hours blocks):
Declaration:
View the: Conditions of Hire & Safety and check list for City of Cockburn Beach Walker 

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Contact

Address

City of Cockburn
Whadjuk Boodja
9 Coleville Crescent,
Spearwood 6163

PO Box 1215, Bibra Lake DC,
Western Australia, 6965

Office opening hours:
8.30am to 4.30pm
Monday to Friday (excluding public holidays)

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Cockburn Nyungar moort Beeliar boodja-k kaadadjiny. Koora, yeyi, benang baalap nidja boodja-k kaaradjiny.
Ngalak kaditj boodjar kep wer kaadidjiny kalyakool yoodaniny, wer koora wer yeyi ngalak Birdiya koota-djinanginy.

City of Cockburn acknowledges the Nyungar people of Beeliar boodja. Long ago, now and in the future they care for Country.
We acknowledge a continuing connection to land, waters and culture and pay our respects to the Elders, past and present.