Blue Travel


Reservation Form

EagleRider Motorcycle Rental
USA

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:
*Card Type
*Card Holder
*Card Number
*Expiration Date
This is a legally binding reservation request and I authorize Blue Travel to disclose my personal information to EagleRider. I hereby confirm my rental dates and authorize EagleRider to charge all rental costs including the sales tax to the credit card listed above. 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:
*Motorcycle Model 1st Choice:
 2nd Choice:
*Pickup Location
*Pickup Date /
*Return Location   One way charges apply.
*Return Date /
*Prepaid Miles
 5.5% Environmental Surcharge and Sales Tax will be automatically added to your credit card balance.
Please visit our Hotel Reservation Service for EagleRider transfer hotels.
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