Renter Name

First Name

Last Name

Date of Pick-Up *

MM

DD

YYYY

Time of Pick-up *

Between 9:00 AM and 5:00 PM

Hour

Minute

Second

AM PM

Date of Return *

MM

DD

YYYY

Time of Return *

Between 9:00 AM and 5:00 PM

Hour

Minute

Second

AM PM

Name of Principle Driver

First Name

Last Name

Principle Driver Birth Date

MM

DD

YYYY

Expiry Date

MM

DD

YYYY

Name of Secondary Driver

First Name

Last Name

Secondary Driver Birth Date

MM

DD

YYYY

Expiry Date

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mobile

(###)

###

####

Phone

(###)

###

####

Optional Equipment Required

Fee Applicable

Propane Fire Pit - $15/day or $75/week (incl. 20 lb tank)

BBQ - $12/day or $60/week (incl mini tank)

Generator - $10/day or $50/week (incl full tank)

Pop Up Shelter - $5/day or $25/week

Camping Chairs - $3/day or $15/week per chair (incl number required in other notes below)