I certify that the information provided is correct and no relevant material/information has been omitted. I understand that this information will be used for the purposes of ensuring safety on site including compliance with other agencies and that any incorrect or misleading or important information that has been omitted may disqualify me from entering site and termination of contract.

I consent to Punchbowl providing information to Government Agencies where required.

I declare that I have completed all sections of this truthfully and shall inform Punchbowl PackCo of any change in my circumstances that affect the answers given above.