Address:
City: State/Province:
Zip:
Country:
Employer:
Phone #
How long?
Address:
City: State/Province: Zip:
Auto Ins. Policy#
Phone/Agent:
*Evidence of insurance policy required
Auto make and license #(if leaving it here):
Trip
Information
Destination/travel route:
Estimated travel miles:
Travel dates:
# of People in your party:
Adults: Children:
Can you drive a stick shift? Yes
No
Driver
Information
*Renters and drivers must have a valid driver license & credit card!
Full name of
Driver/Renter:
Age: Date of Birth:
Driver license #
State: Exp.
Date:
Full name of Driver #2:
Age: Date of Birth:
Driver license #
State:
Exp. Date:
Select any of the options you want by indicating quanity or checking the appropriate
box. (Scroll down to skip options and send)
Folding chairs 5.00 each weekly
Folding table 10.00
first week / 5.00
each additional week
Ice chests 5.00 each weekly
Child Seats 20.00 first week /
5.00
each additional week
Bar-b-que 5.00
each weekly
Porto-potty 25.00
each weekly / 10.00 each additional week
Solar shower (5 gal) 5.00 one
time charge
Lantern 10.00 each weekly
Sleeping bag 5.00 each weekly
Bedding set 15.00 each weekly (includes:
2 sheets, pillows w/cases, fleece blanket)
Tents:
Dome style 20.00
weekly
Dinner canopy 5.00
weekly
How did you find out about us? We’d like to know!
*Credit card and
additional driver information must be given in person or via phone / fax
