Customer Name*

First Last

Cell Number*

Drivers License #*

Country/State/Province

State / Province / Region Country

Expiration Date*

Date of Birth*

Partner/Renter 2 Name

Cell Number

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Employer/Company*

Position

Work Phone Number

Insurance Agent's Name*

First Last

Insurance Company*

Policy Number*

Contact your insurance company and let them know that you are renting an RV. Include the insurance company's fax number, contact person, and your policy number on the application. All insurance information is mandatory and must be complete. We will provide you with the information needed for the insurance binder. Additional insurance is available for purchase from MBA insurance. Please call for quotes and information. Jf you purchase coverage through MBA insurance, an additional insurance deposit of$1000 (refundable) will be due at pickup. This may be paid by check, cash or credit card. If you pay with a credit card a 3% fee will apply.

Phone Number

Agent's Fax Number*

Are you interested in additional insurance?*

Group # Requested*

Unit Number

Price Quoted*

Departure Date*

Weekdays only!

Departure Day of the Week

Time

SUMMER 1-4pm/WINTER 9-4pm

Return Date*

Sunday through Friday only!

Return Day of the Week

Time

SUMMER 8-10am/WINTER 9-4pm

Destination*

City State

Estimated Round-Trip Mileage*

Free Mileage Included

Number of People Traveling (include children)*

Are you traveling with pets?*

Pets require an additional fee of $25. Leave no trace of pets upon return!

Add'l Mileage Charge

40c each or $375 per 1000

Check the options you need (fees apply):

Linens
Towels
Post-Cleaning
TT Generator
TV/DVD
Chairs
Bike/Cargo Rack
Tow w/RV
Delivery

Linen Quantity

Bike/Cargo*

Did your quote include an approved delivery/price?

Yes

Delivery Address

Price Quoted

Other

How did you hear about us?

Have you rented before?*

From here?

Yes
No

List any additional drivers EXCEPT those on your policy

First Last

Other Driver's Phone Number

Other Driver's Auto Policy Number

Insurance Agents Name

Insurance Agents FAX #

Rental fees, mileage, refundable security/insurance deposits and charges for additional services are due upon departure. The refundable security deposit is $500 and is payable by check cash or with credit card. If you pay the deposit with a credit card a 3% credit card fee will be charged. This deposit will be billed apart from the rental fees. Security deposits are refunded within 2 to 7 business days of your return, any additional charges will be taken from this deposit. If you have any damages this will delay your refund. Cancellations with less than 30-day notice you will lose your $500 deposit. If you cancel more than 30 days in advance you will be refunded the $500 deposit less a $100 processing fee. Sorry, no refunds on early returns.

Customer Signature*

Please enter your full name. This is considered your digital signature.

Email Address*

Ok to email?

CAPTCHA

ONLINE RV RENTAL APPLICATION FORM

RENTAL APPLICATION

Rental Application

ONLINE RV RENTAL APPLICATION FORM

RENTAL APPLICATION

Rental Application

Share this: