Please complete all the information requested in the following form.
By submitting this form the applicant agrees to authorise Cosy Cabin Rentals Ltd to
verify applicants details.

Cosy Cabin Rentals Ltd require Date of Birth information for cabin registration on the
"Personal Properties Security Register" and references from two contact people.

On receipt of the completed information we will provide a quote detailing the process for the
rental of the cabin plus availability.

If you have any questions before submitting form please contact us.
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Hirer Details:

Hirers full legal name:
(First and surname)
Current Phone Number:
Mobile Number:
Billing address:
Send invoice(s) attention of:
Email Address:
: enter date in format mm/dd/yyyy or use
date picker icon.
Date of birth:
calendar
ID Type:
ID Number:
Vehicle Registration number:
0

Cosy Cabin Rentals

0800 COSY CABINS
0800 267 922

021 767 563

PO Box 524
Warkworth
New Zealand 0941