P:\Administration\Accommodation\Forms\2014\Other\Overnight Guest.docx 140217
Residents Name: _____________________________________ Room: _____________________
Guest Name: _________________________________________ Guest Mobile: _______________
Relationship [brother, sister, parent, friend, etc.]: ____________________________________________________
Arrival Date: _________________________________________ Time: ______________________
Departure Date: _______________________________________ Time: ______________________
Mattress/Trundle Bed Required [subject to availability]: Yes / No Total Nights Stay: ___________
Comments: _________________________________________________________________________
No accommodation charges apply for 1 2 nights stay, $10 per night accommodation charge applies for 3 5
nights, and if a mattress/trundle bed is required, a charge of $5 per night applies for mattress hire.
You must ALWAYS sign a guest in to EVERY meal at a cost of $10.00 per meal for breakfast or lunch, and $13
for dinner.
A stay of more than two nights must be authorised by the Block/Floor RA before permission is sought from the
Senior Residential Assistant.
A stay of more than five nights is considered a casual guest. Application must be made accordingly, and is
subject to availability. Casual accommodation rates apply.
If approval is not received for overnight guest(s), the resident will be charged $50.00 per guest per night which
does not include meals.
Residents at George Roberts Hall must have signed permission from other residents in their unit if more than
two nights.
Room/Unit: ____________ _________________________________ ___________________________________ ___________________________________
Signature Signature Signature
I have read and agree to the conditions outlined above.
I accept responsibility for my guest's behaviour while at the Hall.
I will accompany my guest to meals and social activities.
I agree to ensure my guest is signed in before every meal and pay accordingly.
Signature: ___________________________________________ Date: ______________________
Duration of Stay
1 - 2 Nights
No accommodation fee, meals and
mattress hire extra.
Residential Assistant
3 - 5 Nights
$10 per night (after second night),
meals and mattress hire extra.
Residential Assistant
(RA must also sign above)
Office Use Only
Mattress Required:
Mattress Number:
Yes / No
Applicant (if unsuccessful)
Date Taken:
Date Due:
Residential Assistants
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