Mid-Florida RV Rentals Inc Lewis Ave, Gibsonton Fl Ph: Fax:

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1 Reservation Application Mid-Florida RV Rentals Inc Lewis Ave, Gibsonton Fl Ph: Fax: Total Pages: (5) (Be sure to review and sign rental policy and terms of contract upon receipt) Legibly complete and return via or via fax: I) Applicant Information: Name: DOB / / Phone NO: Home: Work: Cell: Address: Fax: Address: Apt/Unit: City St Zip: Preferred Method of Contact: _ Home Phone _ Work _ _ Fax Time: EST _AM _PM Employer: Employer s Physical Address: City State Zip Years of Motor Home Exp First # in Party: Adults Children: Referred by: _Repeat _Referred _Web _RV Dealer Other II) Trip Information: (3-Day minimum required) Depart Date: / / Time: AM _ PM (Between 9:30 A-3:00 P): _ Tampa or Return Date: / / Time: AM _ PM (Between 9:00 A-12:00 P): _ Tampa or Note: All rates are pickup and drop-off for Tampa, Fl, by appointment; other arrangements available at additional cost. Destination: Estimated Miles Round Trip Are you thinking about purchasing a RV in the near future? Yes No III) Vehicle Requests: Requested Coach: Size or Class: ft: Class: Gas _ Diesel Specific RV Request: We will try to accommodate your request, while we reserve the right to substitute as needed. Other Special Requests:

2 V) List All Anticipated Drivers (copies of Drivers Licenses are required) 1) Full Name: DOB: / / Exp Date: / / License No: State/ Country of Issue: 2) Full Name: DOB: / / Exp Date: / / License No: State/ Country of Issue: VI) The above is true and correct to the best of my knowledge: x Date: Yes I wish to add a convenience package for $ Initial Convenience Package Includes Two sets of Sheets and Blankets Four Towels and wash cloth Full set of pots and pans Full set of eating utensils with cooking utensils Coffee Maker 4 large drinking glasses 4 coffee mugs 4 large dinner plates 4 small plates 4 bowls ***Pillows not included with package*** There will be up to $200 charge for items missing upon return.

3 Mid-Florida RV Rentals Riverview, FL Ph: Fax: Credit Card Authorization Mid Florida RV Rentals would like to thank you for your business and will strive to exceed your expectations. For your protection, it is necessary for this authorization form to be read, signed and returned either in person, by mail, or fax to confirm the reservation to be charged to your account. Charges will occur as follows unless otherwise pre-arranged: 1) Based on your reservation request we will send you an Agreed Rates contract indicating all charges for your rental for you to accept and sign, insurance cost may be separate, 2) Your card will be charged the required deposit as stated on the Agreed Rates contract, upon receipt of the signed reservation application and this authorization, 3) 30 days prior to your scheduled departure, your card will be charged the balance of the amount owed per the Agreed contract, as well as any related separate insurance charges. 4) Upon return of the coach, the card may be charged for additional usage, check-in or damage charges not covered by insurance. 5) The return of your deposit will be within 14 days from the day of the RV is returned. Name (Print-as it appears on card) Company Name (if Company Card) Visa _ Master Card _ Discover We do not accept American Express Credit Card No: Signature Panel Security Code Expiration Date: / / Billing Street Address: Apt/Unit City: ST/ Province; Zip Signature as it appears on the above card, authorizes Mid-Florida RV Rentals to charge my credit card for services and costs due for the rental of a motor home. Include a legible copy of the front and back of your credit card Authorized Signature: X Date:

4 Mid-Florida RV Rental Terms & Conditions Ph: Fax: Read carefully, sign and return with credit card authorization indicating you accept all rental policies. Renter Print Sign: Date: Mid-Florida RV Rentals (hereafter Mid-Florida ) wants to thank you for your interest in our company. We promise we will strive to do our best to exceed your expectations of service by providing motor-homes of the highest quality and cleanliness. This describes many of the policies associated with renting a motorhome, this is not a substitute for the contract terms,which we suggest you review upon receipt. We hope your RV experience creates memories to last forever. It is your responsibility to return the motor-home in the same condition in which you departed, and you will be liable for any damages. Initial Payments: All reservations require a deposit, which, once you have departed are applied as security deposit against damages and check-in charges. Deposits are refunded, usually within 14 days following return of the coach less any check-in or damage charges. The deposits are usually $1000, depending on the coach. Your credit card will be charged the full rental payment 30 days prior to departure. Reservations made within 30 days require full payment immediately upon reservation. Cancellations must be in writing and are subject to a $ processing fee; with cancellations less than 60 days prior to departure subject to $250 fee. All monies collected are non-refundable if cancellation occurs within 30 days of departure. Forfeited balance may be applied towards a future rental within 1 year. _ Equipment Review & Orientation is provided to familiarize you with coach operations. This orientation usually takes about 1 hour. Most coaches are equipped with dining, sleeping accommodations, cabinets, closets, stored fresh water, kitchen, bathroom, sinks, shower, flush toilets, water and waste holding tanks, generator, range, refrigerator, furnace, air conditioner, power steering, automatic transmissions, AM/FM stereo. Some units may be equipped with Television, DVD/VCR, Satellite and other amenities. Insurance is required on all rentals and is to be provided by a carrier approved by Mid-Florida. Personal vehicle insurance will not suffice unless an approved binder satisfactory to Mid-Florida naming Mid-Florida RV Rentals Inc and respective vehicle owner as additional insured is provided 7 days prior to departure. This protection is separate from the rental contract. Damages of any kind to the motorhome will be charged to the card number on file up to $ It is your responsibility to return the motorhome in the same condition in which you departed. The insurance deductible is $ on all motorhomes which will be charged for any damage costing greater than the damage deposit of $ Interior damage to the motorhome of any kind is not covered by insurance and will be charged fully to the card on file. Driver s must all have a valid driver s license, be at least 25 years of age with a clean driving record satisfactory to Mid-Florida.

5 Fuel & Propane tanks will be full upon departure. To avoid check-in charges of $5.00/gal+$25.00 technician fee, the vehicle will need to be returned full of fuel and propane. Prep Fee There is a $ prep fee added to each reservation. This fee includes a fully clean and sanitized RV stocked with RV special toilette paper and waste tank chemicals. This fee also includes the waste tank dump fee. We do not require you to bring the RV back with waste tanks empty. This is the only additional fee to the rental price. _ No Smoking is allowed in any of the coaches and evidence of smoking including but not restricted to odors, ashes or butts will result in forfeiture of your full deposit at the sole discretion of Mid-Florida personnel. _ Departure and Returns are by appointment during designated normal business hours M-F. Orientations can last 1 hour with returns only slightly less. Returns are due back by 3:00PM. Returns from 3:30pm to 9:00pm will be charged ½ day rental and returns after 9:00pm will be charged a full extra day rental. Departures are scheduled 8:30 AM to 5:00 PM. Off hour arrangements can be made. _ Thank you Mid-Florida RV Rentals Inc. Riverview Fl, Ph: Fax: