CONTACT US

Phone: 0427 691 250
Email: rian.ems@bigpond.com

Event Booking Request

Please note that completion of this form does not constitute an agreement for the provision of services, one of our staff will be in contact with you to discuss your needs and provide you with a quotation.

It is important that you provide us as much detail as possible so that we may provide you with an accurate quotation for services, ensure appropriate standards of coverage for your event and that Health & Safety standards are maintained for competitors, spectators, event & EMS staff.

TERMS AND CONDITIONS of CONFIRMED BOOKINGS

EVENT BOOKINGS

1. Event bookings will only be accepted on EMS booking forms, which can ethier emailed or faxed to our office.
2. Confirmation of all bookings will be sent via return email or fax to the party making the booking.
3. Once the booking has been confirmed and the quoted price accepted then both parties will be bound under common law to a contract of acceptance with the following conditions.

EVENT CANCELLATION by Client

In the event that the booking is cancelled by the client, the following fees shall apply.

1. Where a booking is cancelled by the client within 14 business days a fee of 50% will be applied.
2. Where a booking is cancelled by the client within 7 business days a fee of 75% will be applied.
3. Where a booking is cancelled by the client within the 24hrs of the event then 100% of the fee will apply.

Event Medical Solutions reserves the right to waiver these fees

Company Information

Company Name:
Company Contact:
Company Position:
Address:
Suburb/Town:
State:
Postcode:

Event Information

Name of Event:
Date of Event:
Type of Event:
Times Required:
Start:
Finish:
No. Competitors:
No. Spectators:

Event Location

Venue Name:
Street:
Suburb/Town:
State:
Postcode:
Map Reference:
GPS Co-ordinates:

Event Contact

Event Contact Person:
Telephone No:
Mobile No:
Email:

Service Level Requirements
(Please note that our staff may make recommendations on service level requirements based on the information supplied in this request form.)

First Responder:		Paramedic:
Nurse:		Doctor:

Other Relevant Information


Miscellaneous

Are Meals/Refreshments Supplied for Staff?
Are Meals/Refreshments Avaliable on Site?
Is Car Parking Avaliable for our Staff?