online rental reference form - WaiverElectronic

First and Last Name: * Please enter your name.

EMAIL: * Please enter your email.

HOME ADDRESS:

Please enter address.

CELL PHONE #: * Please enter your phone number.

ROOM NUMBER * Please enter your answer here.

DRIVER’S LICENSE#/PASSPORT# * Please enter your answer here.

RENTAL TYPE & DURATION * Please enter your name.

Date of Birth: *

Please enter valid date.

STATE * Please enter your answer here.

GAS & OIL: Customers are responsible for all gas and oil. Customers are responsible for maintaining the fuel level. * Please check it here.

RENTAL TIME: Time is calculated from the time you leave the dock until the time you return to the dock. There is a 2 Hour Minimum rental charge. After the first 2 hours, the charge is prorated every 15 minutes based on the 2 hour rate. ½ Day (4 HR) and Full Day (8 HR) pricing only applies to rentals longer than 3 Hours. * Please check it here.

WATERCRAFT DAMAGE LIABILITY: If any damage to the watercraft occurs while in the customer’s possession, the customer acknowledges they are financially liable for the entire amount of damage. MINIMUM DAMAGE CHARGE: $400.00 * Please check it here.

INSURANCE AVAILABLE: $40.00. Covers Rental Boats ONLY. Does not cover property damage, propeller damage, customer negligence or damage done to other watercraft. It does cover everything on the interior of the boat, fiberglass above the waterline and all towable rentals. * Please check it here.

I Accept Insurance. *

Yes

No

Please select at least one choice above.

BOAT PROPELLER DAMAGE/PWC CAPSIZE DAMAGE: If a Boat returns with ANY damage to the propeller, there will be a $400.00 minimum charge for aluminum and a $1600.00 minimum charge for dual stainless steel. If PWC capsizes and fills with water due to operator negligence or if PWC is operated in shallow water there will be a $200.00 minimum charge. NO EXCEPTIONS. * Please check it here.

CLEANING FEE: If a watercraft is brought back excessively dirty, there will be a minimum cleaning charge of $100.00. (Take off what you bring on.) * Please check it here.

DUI OR RECKLESS DRIVING: I certify that I have no driving under the influence or reckless driving citations within the past 3 years. * Please check it here.

TOWING: If a watercraft requires towing or assistance due to customer negligence including a lost Kill Tether, there will be a $125.00 minimum charge. ABSOLUTELY NO TOWING of ANY watercraft will be allowed under any conditions. * Please check it here.

ABSOLUTELY NO DRUGS OR ILLEGAL SUBSTANCES: No goods, weapons, documents or drugs shall be carried which would involve risk of seizure, capture, detention, arrest or repatriation by any government or law enforcement agency. * Please check it here.

By checking this box, I agree ... * Please check it here.

CUSTOMER SIGNATURE: *

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EAST SHORE ACTIVITES AGENT: * Please enter your name.

Online rental reference form helps you in waiver management.