QTA Application Form

QUARRY TRAINING AREA APPLICATION
Applicants must read the Training Area Policy and Conditions for Use before completing this form.

The completed Application Form must be submitted at least 4 weeks before first use.

If you have any queries please email qta@wagga4wdclub.org
Date Training Area Required
From*

DayMonthYear
Date
To*

DayMonthYear
Date
Applicant/Organisation Information

Mandatory
Applicant Name*
Address

Street Address

Street Address Line 2

CityState

Post Code
Email*
example@example.com
Name of Authorised Officer*

First NameLast Name
Phone*

Primary NumberSecondary Number
Activities

Please list all activities you will be conducting at the QTA (e.g. 4x4 driver training, education program).
Activities

Activity NameNumbers
Activity NameNumbers
Activity NameNumbers
Activity NameNumbers
Vehicle Information

Please list what types, and how many, vehicles you expect to be using at the QTA during activities.
Type of VehicleNumbers
Type of VehicleNumbers
Type of VehicleNumbers
Type of VehicleNumbers
Hygiene
On site toilet facilities are now available for use.
Terms and Conditions
I have read and agree to abide by the terms and conditions of the WW4WDC QTA Policy and Conditions of Use.
I agree that participants will abide by the QTA Policy and Conditions for Use.
I confirm that the person conducting the activity has appropriate skills and authority to act on behalf of the organisation.
I confirm that the person conducting the activity has full responsibility for the safety of all participants.
I confirm that a Risk Assessment for the activity has been undertaken and Risk Management Plan is attached
Public Liability insurance and Certificate of Currency is attached.
I agree that the key shall be returned within 24 hours of completion of the activity.
Please attach your Risk Assessment and Public Liability Insurance Certificate of Currency.

Cancelof
Please verify that you are human*
Should be Empty:

QUARRY TRAINING AREA APPLICATION

Date Training Area Required

Applicant/Organisation Information

Activities

Vehicle Information

Hygiene

Terms and Conditions