COASTALWHEELS BIKE RENTALS
BIKE RENTAL AGREEMENT
Name of RENTER
First Name
Last Name
Type of Bike
Please Select
Adult Trike
Adult Beach Cruiser(26")
Midsize Beach Cruiser(24")
Kids bike (16")
Kids bike (20")
Trailer for Kids
Kids trail-a-Bike(kids-ride-along)
Name of RENTER
First Name
Last Name
Type of Bike
Please Select
Adult Trike
Adult Beach Cruiser(26")
Midsize Beach Cruiser(24")
Kids bike (16")
Kids bike (20")
Trailer for Kids
Kids trail-a-Bike(kids-ride-along)
Name of RENTER
First Name
Last Name
Type of Bike
Please Select
Adult Trike
Adult Beach Cruiser(26")
Midsize Beach Cruiser(24")
Kids bike (16")
Kids bike (20")
Trailer for Kids
Kids trail-a-Bike(kids-ride-along)
Date of Birth
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Basket
Please Select
Yes 1
Yes 2
Yes 3
No Basket
Email
example@example.com
Phone Number
Please enter a valid phone number.
Helmet
Please Select
I have my own
Small
Medium
Large
Date Need
-
Month
-
Day
Year
Date
Date Return
-
Month
-
Day
Year
Date
Delivery Address
Street Address (Please Enter Gate Code If Needed)
Delivery Address
City
State / Province
Postal / Zip Code
waiver
I have read and agree to coastal wheels terms and conditions
Signature
Signature
Signature
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: