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Please select the rental package
*
1 Month -
$890.00
3 Months -
$2,000.00
12 Months (1st Wk) -
$135.00
N.D.I.S - 1 Month -
$600.00
D.V.A - 1 Month -
$600.00
Full Name of Responsible Person
*
When would you like the Rental Kit?
*
Phone
*
Email
*
Delivery Address
*
Drivers Licence - Front
*
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the system? Phone
Drivers Licence - Rear
*
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List who will be using the system?
*
*You can add other people at anytime
List any alternate addresses
Please upload a copy of your N.D.I.S Participant Agreement
*
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You can redact out the budget, we are just wanting to see the name of the participant and the dates
Please upload a copy of your D.V.A Gold Card
*
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ANNUAL SPECIAL CONDITION
*
I agree to the special terms for the annual commitment listed below
This agreement is for a very reduced weekly price dependant on a 52 week commitment of $135 paid per week for the week coming up - totalling $7,020. If you decide to pull out early you will need to bring the total payments up to the standard level of $900 for the first 4 weeks, a total of $2000 for the first 12 weeks and $187.5 for each week after 12 weeks. By signing this agreement, you are accepting this condition.
Read
Terms & Conditions (T&C's)
Read
Care & Consent Agreement
*
* I agree to the T&C's, Care & Consent Agreements
Signature
*
Clear Signature
Total
$0.00
Select Payment Method
Direct Deposit
Pay ID
Credit Card
PayPal or Apple Pay
Direct Deposit Payment
Please complete your booking form submission.
We will email you our bank account details within one business day.
Please click Book Now and your rental will be sent once payment has been received.
PayID Payment
Please transfer payment using the details below:
PayID: 42638666869
PayID Name: Valor Pty Ltd
Please use your full name as the payment reference.
Please click Book Now and your rental will be sent once payment has been received.
Credit Card
*
Card
Name on Card
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