Jukebox & Karaoke Hire Booking Form

Online Booking Form

First Name*

Surname*

Email*

Home Address*

Phone (Home)

Phone (Work)

Phone (Mobile)*

Select your Jukebox*
Plus $50 Refundable Bond

Microphone for Speeches On Audio Only Jukeboxes

$20 Microphone

Function Date*

Function Time*

Function Address*
Please Note: We do not deliver to halls

Any Steps?
*Maximium of 3 steps only for a Push Button Jukebox

Number of Steps*

Extra Delivery
(Please refer to the Delivery Area Map to check your Zone)

WITHIN FREE DELIVERY ZONE

ZONE 2

ZONE 3

Need to Choose a Delivery Time?
$20 Extra eg. For Surprise Party, Wedding, Early Party etc

NO, can be anytime

YES, I've specified a time in the Notes Section Below

Payment Preference
BSB 638-060 Account No: 7481764 Account Name: A & A Stewart Jukebox Hire

Bank Transfer

Cash on delivery

Notes / Special Delivery Instructions

I have Read and Agree to the Rental Agreement