BOOKING FORM

FULL NAME:…………………………………………………………………………….

E-mail:………………………………………………

Hire Date from:………………………………………………………..

Hire Date to:……………………………………………………………

Address…………………………………………………………………………

…………………………………………………………………………………..

………………………………………………………………………………….

Postcode:………………………………………………………………………..

Tel Home:………………………………Mobile:……………………………

Number in party Adults……………..Children……………………………….

Optional extras(please state)…………………………………………………….

…………………………………………………………………………………..

Main Driver Details. (Insurance Included in charge)

Name…………………………………………………………………………..

Address………………………………………………………………………..

D.O.B:……………………………………………………………….

Occupation:…………………………………………………………

Employers Name:……………………………………………………

Employers Telephone Number:……………………………………..

Driving Licence Number………………………………………………

Valid from……………………………..Expiry Date…………………………….

Issued by DVLA Yes/No

If no please give details.

Do you have any motoring convictions? Yes/No

If ‘yes’ please specify details of codes of any penalty points:

Have you ever been refused insurance? Yes No

If ‘yes’ please supply details

Have you ever had any road accidents in last 2 years? Yes No

If ‘yes’ please give details

Any physical or mental problems that may effect driving? Yes No

Please give details if you would like to be met at a train station local to ourselves.

Bournemouth or Christchurch. (charge of £5.00)

I have read and understood your terms and conditions. (please see website)

I agree that the details given on this form are correct and if any of the details change between now and the hire date I will advise South Coast Campers.

Sign here:………………………………………………………………………………

If you need further details please do not hesitate in contacting us.

OFFICE USE ONLY

Passport number:

Utility Bill Account number:

Driving Licence:

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