Blue Travel


Reservation Form

Britz Southern Africa - 4WD Campervan Rental

Please fill in this form completely, and be as specific as you can. Items marked with an asterisk (*) are required information. You may also print out our Fax Form and fax it to one of our worldwide offices:

USA Toll Free
1-877-605-6888		Australia
+61-2-9475-4888		Germany
+49-69-3809-9888
 
CUSTOMER:
  Mr. Mrs.
*Last Name
*First Name
*Street
*City, State & ZIP/Postal Code
*Country
Tel. (+ area code)
Fax (+ area code)
*E-Mail
PAYMENT:
*Credit Card Type
*Card Holder
*Card Number
*Expiration Date
American Express: I.D. Number
MasterCard & VISA: Last 3 digits
on the back of the card
This is a legally binding reservation request and I authorize Blue Travel to disclose my personal information to Britz 4x4 Rentals. I give permission for Britz 4x4 Rentals to charge my credit card accordingly with the appropriate hire costs. I acknowledge that I am the authorized card holder of this account, have read the Terms and Conditions and agree to abide by them.
RESERVATION:
*Vehicle Type
*Rental Option
*No. of Passengers
*Pickup Location
*Pickup Date
*Drop off Location One way charges apply.
*Drop off Date
Flight Details /
Transfer Request
 
ADDITIONAL COMMENTS:
To make a reservation please click on the Send Reservation button above.
THANK YOU for your business!
 
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Last modified: 19 Aug 2008 18:45