Guest Application Form 350

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Primary Applicant's Name *

FirstLast

Co-Applicant's Name

FirstLast

Current or Last Address *

Address Line 1Address Line 2CityState / Province / RegionPostal CodeCountry

How long did you stay at this address? *Start Date *About you *quiet, tidy, respectful of shared spaces, interests …Employment & schedule: *work status + typical hoursLength of stay: *preferred lease term + earliest move-in datePets: *which and how manyCars: *how many carsAllergies, Health Issues, Disabilities: *provide detailsReferences: *2–3 lease/work refs (police check required)

If you stay between

1 – 3 weeks = 1 week security/cleaning deposit
3 – 12 weeks = 2 week security/cleaning deposit
12 – 24 weeks = 3 week security/cleaning deposit
24 – 52 weeks = 4 week security/cleaning deposit

Accommodation Fee Details:

Per week: 300
Please make payments to:
Lia Spoerl, BSB: 062-948
Acc # 1648 8666

Please upload the receipt for your bank transfer. *

Click or drag a file to this area to upload.

Please upload some form of photo ID *

Click or drag a file to this area to upload.

Do you have any additional certificates? For instance: Rent Check, Police Check, NDIS Worker Clearance, Working with Children Card

Click or drag a file to this area to upload.

Conditions *

I hearby agree to the terms and conditions and verifiy the information I have detailed to be correct at the time of submission.

Additional Terms

Keep the pool area and the area around the house tidy and maintained.
You are responsible for removing your own rubbish immediately.
Adding new plants is welcome with owner approval.

Stay at your own risk. Berry Springs Farmstay is a rural property with animals, tools, uneven ground, and a swimming pool; by visiting or staying here, you accept these inherent risks. We are not responsible or liable for any injury, illness, loss, theft, or damage to persons or property arising from your visit. Please follow all safety instructions, use facilities responsibly, and keep children under active adult supervision at all times. Notify us immediately of any hazards or incidents.

Guest Signature *

Clear Signature

This agreement shall be governed by and construed in accordance with the laws of the state of Northern Territory, Australia.

Date *

By submitting this form, I declare that I’m prepared for my farmstay, understand the
expectations and what to bring, and I agree to the
Guest Terms & Conditions.

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