Accommodation Enquiry - Saltbush Balnarring Beach

Booking Enquiry Form

This is a booking enquiry for accommodation at Saltbush, Balnarring Beach.

Please complete the form below and a team member will contact you within 3 business days.

Name of Primary Contact*

First Last

Phone*

Email*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Emergency Contact Name

Phone

Will you need a wheelchair accessible house or other additional needs for the house?*

Please outline the additional needs for the house (e.g. a house with a bath, 4 bedrooms etc.)

Who will be funding this stay?*

What is the NDIS provider or community organisation funding your stay?*

Do you or a member of the booking have a Health Care Card?*

How many adults are staying in this booking?*

Please provide the full name and phone number for each adult.

How many children/underage guests are staying in this booking?*

Please provide the full name and age for each underage guest.

Please provide the full name and age for each underage guest.*

As a not for profit, we try to ensure our service is reaching guests who need it most. Please tick any circumstances that apply to you:

Circumstances 2*

Do you identify as Aboriginal and/or Torres Strait Islander?*

How did you hear about Saltbush?*

Sign up to our mailing list.

I would like to hear about Saltbush availabilities, newsletters and other events.

By submitting this booking form, you agree to the Saltbush, Balnarring Beach Terms & Conditions.*

https://saltbushbalnarringbeach.org.au/terms-and-conditions/