Mooirivier Beskerming Please complete this form if you intend to leave the premises for 24 hours or longer Leave Intent form Name:(Required) Surname:(Required) Email Physical AddressPlease choose one(Required) Home Complex Arrangements during time of absence Time of absenceAbsent from:(Required) DD slash MM slash YYYY Time of departure: Hours : Minutes AM PM Date return:(Required) DD slash MM slash YYYY Time of return: Hours : Minutes AM PM KeyholderWill you be leaving your keys with a keyholder?(Required) Yes No Will the premises be occupied in your absence? Yes No In Case of EmergencyDoes the above stated keyholder have permission to make decisions with regards to the property in your absence? Yes No Other people/Service providers allowed on premises(Required)Family MembersGarden ServicesDomestic WorkerOtherAny dogs on premises?(Required) Yes No Would you like to receive an SMS everytime your alarm is activated and deactivated while you are on holiday? (SMS’s are free of charge)(Required) Yes No
