Online Form - Parks & Reserves Memorial Application Please complete this form if you are planning a memorial event / scattering of ashes in a Town Park or Reserve area. Title* Select an Option CO CR DR EST MISS MR MRS MS N REV U * Required Field. Given Name* * Required Field. Surname* * Required Field. Address* * Required Field. Email Address* * Required Field.* Enter valid email address Phone / Mobile Number* * Required Field.* Enter valid phone number I understand and agree that the gathering / ceremony must remain low-key* YesNo * Required Field. I understand and agree that public access or use of the area will not be interferred with (the area remains open to the public). Parking bays are unable to be reserved or blocked off.* YesNo * Required Field. I understand and agree that only ashes are to be released in the earth. Flowers or other memorial items should not be placed/left in the park or reserve.* YesNo * Required Field. I understand and agree that ashes will be spread out (not in a pile) and lightly covered in soil away from the root system of plants, trees and lawn to minimise environmental impact.* YesNo * Required Field. I agree that ashes will be scattered in a secluded area, ideally away from other people (note the wind direction) and avoiding main pathways.* YesNo * Required Field. I have read, understood and agree to the General Conditions of Hire* YesNo * Required Field. Proposed Park or Reserve for Memorial / Ceremony / Spreading of Ashes* * Required Field. Proposed Date* * Required Field. Proposed Start Time* * Required Field. Proposed End Time* * Required Field. Nature of Memorial (Spreading of ashes, gathering only etc)* * Required Field. Proposed number of guests* * Required Field.* Enter valid number Comments Type the code from the image: Do not fill this textbox.