No Contract / Non Consent Forms to submit to Council

TO: The Administrator, Port Macquarie-Hastings Council

RE: NO CONTRACT, NON CONSENT TO ACCEPT SUPPLY OF FLUORIDATED WATER

I, ................................................................................(full name), DO NOT CONSENT to having fluoride (in any form) or any other substance, administered to me through the Port Macquarie-Hastings town water supply for the purpose of medication or supplementation.

Furthermore, I DO NOT CONSENT to any ALTERATION AND/OR VARIATION in the implied terms of the established implied CONTRACT I have with the Port Macquarie-Hastings Council (or whatever the designated name and supplier may be from time to time) on the one part for the supply of drinking water, clean, pure and uncontaminated, in return for me, on the other part, by payment of a compulsory levy for the provision of such clean pure uncontaminated drinking water to my premises at:

(address) ..............................................................................................................................................
SIGNED ........................................................, DATED, this .................day of ........................2012
 

If you are a rate-paying Hastings resident, or if you pay you're a renter and pay for your water usage, then it is important that you complete this form to advise the council that you donot intend to pay the water volume component of your rates whilst fluoridation chemicals are being added to your water supply. 

Please copy for your own records before sending completed forms to Port Macquarie-Hastings Council. If you'd like to be recorded on our database, email Gwarehouse through our website contact page.

Download Printable Forms here...

Find out how you're covered by Consumer Law here.....

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