Bike Rental Form 2022
Name
*
First Name
Last Name
E-mail
*
e-mail address
Phone Number
*
-
Country Code
Phone Number
Hotel/Flat address
First Day of rental
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
January
February
March
April
May
June
July
August
September
October
November
December
Month
2022
Year
Last Day of rental
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
January
February
March
April
May
June
July
August
September
October
November
December
Month
2022
Year
Days of rental
*
Favourite Model
*
Hersh Bellagio RF913 Disc at € 70 per day
Pinarello Dogma F10 at € 50 per day
Cervélo R3 Disc at € 50 per day
Pinarello Prince at € 40 per day
Pinarello GAN at € 40 per day
Do you want to add insurance against accidental damages to the bike
*
YES
NO
€ 5 total per bike - € 25 deductible
Pickup place?
*
Direct at the shop after 9 am
Direct at the shop the day before after 6 pm
Height in centimeters / feet / size
*
Are you bringing your own saddle?
*
YES
NO
Are you bringing your own pedals?
*
YES
NO
Special Requests
Submit
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform