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 machine(s). You may call to double check availability. NOT accepting half day rental reservations until April 12th.
(*) Required information
*First and Last Name:
Cell Phone:
*Home Phone:
*Email:
*Billing Address: Make sure this matches the address on file with your credit card company to avoid any issues.
*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/Postal code:
Country:
*Driverse License #:
*State Issued:
*Credit Card #: Please double check for typo's
*CC Experation Month/Year: Select...010203040506070809101112/ Select...202220232024202520262027202820292030
*CC Cvv Code:
A 4% convenience fee will be charged in addition to the tax for using a credit card for the rental. To avoid the additional 4% fee, check the paying cash box. The security deposit must still be put on a credit card.
Paying Cash
*Starting Date: (Month/Day/Year)
*Ending Date: (Month/Day/Year)
Rentals Times:
Full-day 8AM-4PM
Full-day 9AM-5PM
Half-day 8AM-12PM
Half-Day 1PM-5PM
*Select Rental Machine(s): (Price does not include 9.2% tax and 4% convenience fee) (Does include Gas up to 1 tank)
2-seat Polaris RZR XP1000 $400/day
2-seat Kawasaki KRX 1000 $400/day
2-seat Can-Am Commander 1000 $400/day
4-seat Polaris RZR XP1000 $450/day
4-seat Can Am Commander 1000 $450/day
4-seat Can Am Maverick Sport 1000 $450/day
Polaris Ranger Crew 900 $450/day (Only available for 2 adults and children)
Any special notes/request type them here:
Within a few hours after submitting this form within normal business hours 9am-5pm a rental agreement will be sent to the email listed above to e-sign. If you do not see the email make sure you check your spam/junk mail. The email should be coming from amy@rentalphoenixaz.com
Please confirm all the above information is correct especially the billing address, if the billing address is not correct you may see 2 charges for the security deposit.
By signing this form I agree to be charged for the above selected date, time, and machine(s) to be rented.