Blue Travel, Inc. - RESERVATION FORM - MAUI Rentals Please fax to USA Toll Free: 1-877-605-6888 or Australia: +61-2-9475-4888 Germany: +49-69-3809-9888 . CUSTOMER ADDRESS: (please print) . : ___ Mr. ___ Mrs. . *Last Name: _____________________________________________________ . *First Name: _____________________________________________________ . *Street: _____________________________________________________ . *City: _____________________________________________________ . *State, ZIP: _____________________________________________________ . *Country: _____________________________________________________ . Tel +Area Code: _____________________________________________________ . Fax +Area Code: _____________________________________________________ . *E-Mail: _____________________________________________________ . . PAYMENT: . *Card Type: _____ MasterCard _____ VISA . _____ American Express + ID _________________________ . *Card Holder: _____________________________________________________ . *Full Cardnumber: _____________________________________________________ . *Expiration Date: _______________ (Month / Year) . This is a legally binding reservation request and I authorize Blue Travel to disclose my personal information to MAUI Rentals. I give permission for MAUI 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: ___________________________________________________ . *No. of Passengers: ___ *Rate: __________________ . * Pickup Location: _____________________ *Date: __________________ . *Drop off Location: _____________________ *Date: __________________ . . ADDITIONAL COMMENTS: . . . . . . . . ____________________________________ ___________________________________ City and Date Signature