This form MUST be filled out and e-signed by the credit card holder 25yrs or older. The card holder on this agreement MUST be present with their credit card and drivers license upon pickup of the vehicle(s).

(*) Required
*First and Last Name:
*Phone:
*Email:
*Billing             Address:
*Billing City:
*Billing State:	Select... AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Leave blank for outside US
*Billing Zip code:
*Driver's License #:
*State Issued:
*Credit Card #:	Please double check for typo's
*CC Expiration   Month/Year:	Select...010203040506070809101112/ Select...20242025202620272028202920302031
*CC Cvv Code:

*Starting Date:
*Ending Date:
*Rental Times:	Select...9am-4pm Full-day
Extra hours	Select...No Thanks4pm night before pickup ($100 add on per vehicle)8am morning after return ($100 add on per vehicle)Both night before pickup and morning after drop-off ($200 add on per vehicle)
*Select Vehicle:	(Price does not include 9.2% tax and 4% convenience fee) Select...2-seat Kawasaki KRX 1000 ($400/day)4-seat Kawasaki KRX 1000 ($500/day)
Notes/Requests:

How did you find us?

Select...Online SearchSocial mediaHotel FlyerReferralDrive byRadioOther

1. RENTER AGREES TO THE FOLLOWING CONDITIONS:  a.     I understand the above credit card will be used for both the security deposit ($2500/vehicle) and rental. All money will be due on the day of the rental.  b.     Cancellations less than 7 calendar days do not qualify for a refund. Rescheduling may be available.  c.     If the rented machine becomes unavailable do to damage or mechanical failure before your rental, we will give you another machine with the same or more seats. If we do not have any other machines to offer you, you will be notified ASAP and will receive a full refund.   CLICK HERE To accept all Terms and Conditions

Within a few hours after submitting this form within normal business hours 9am-4pm a confirmation email will be sent. If you do not see the email make sure you check your spam/junk mail. The email should be coming from amy@rentalphoenixaz.com

By signing this form I agree to be charged for the above selected date, time, and machine(s) to be rented.

Date: 1/21/2025

Renter Name:

Signature:

I accept the terms of this agreement. Please wait...