Bike Rental Form Please fill out this form before you come to the shop to rent your bike Name on Reservation Phone Number Home Address (City, State, Zip) Style of Bike Hybrid Road Mountain Full Suspension Mountain Electric To select or deselect multiple options, hold the "Ctrl" key when clicking. Date of Rental Length of Rental -Select One- Day Week Month Bi-Monthly Do You Need a Helmet Yes No Do You Need a Lock Yes No To Be Filled Out at Time of Pickup Credit Card # Credit Card Expiration Credit Card CVV Name on Credit Card Bike Rental #/Description Bike Serial # Bike Value Customer Signature Date Bike Rental Liability Disclosure I, for myself and any minor children for whom I am parent, legal guardian or otherwise responsible, release the bicycle shop, agents, and employees from any liability for damage or injury to myself or any person or property resulting from negligence, adjustment, selection and use of this equipment. I, understanding the inherent risk involved in using this equipment, accept the full responsibility for any and all such damage or injury, which may result. I accept for use, as is, the equipment in good condition and accept the full responsibility for care of equipment while in my possession. I will be responsible for the prompt replacement at full retail value of all rental equipment not returned or damaged, other than reasonable wear and tear, which results from the use of this equipment. I agree to return rental equipment by agreed date in clean condition to avoid additional charges. All instruction on the use of the equipment has been made clear to me and I understand the function of the equipment. By filling out this form and clicking Submit below, I accept the terms of this agreement and accept responsibility for the above charges. Keep this field blank
