Waldorf Ride Reservation Request
What type of ride are you needing?
*
Please Select
Transportation to/from airport
Transportation to/from medical facilitiy
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Waldorf Airport Transportation Request Terms
Waldorf Transportation
ONLY
provides rides to and from the Mason City Airport and Bus Station, not any other airport.
Waldorf transportation does not cover hotel costs.
Waldorf transportation does not cover bus, taxi, shuttle or ride service costs from any location.
Rides to Mason City are
FREE
if booked 72 hours in advance, especially on a weekend.
If booked less than 48 hours in advance or cancelled within 24 hours there will be a $10 charge.
Please check box to acknowledge that you understand and accept the terms above
I acknowledge & accept the terms noted above
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Waldorf Medical Transportation Request Terms
If you cancel the day of the appointment, there will be a $10 charge
Please check box to acknowledge that you understand and accept the terms above
I acknowledge & accept the terms noted above
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Contact Information
Name
*
First Name
Last Name
Cell Phone Number
*
-
Area Code
Phone Number
Email Address
*
Waldorf Email Address
*
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Number
*
-
Area Code
Phone Number
Emergency Contact Email
*
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Waldorf Airport Transportation Ride Request Details
Do you need picked up or dropped off?
Please Select
Pick up from Airport
Drop off to Airport
What date do you need picked up/dropped off?
*
-
Month
-
Day
Year
Date
What time do you arrive/leave Mason City?
*
Hour Minutes
AM
PM
AM/PM Option
How many bags do you have?
Please Select
0 Bags
1 Bag
2 Bags
3 Bags
Other ride options:
Find a friend who is willing to help
Ask a coach or possibly another Waldorf staff member
Jefferson Bus
Goes to MSP: prices $30-50 (we can supply a ride to the bus station to Mason City only)
Mason City Cab (641.423.4167)
UBER
Lyft
Signature & Date
Signature
*
Type name to sign form
Date
-
Month
-
Day
Year
Date Picker Icon
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Waldorf Medical Transportation Ride Request Details
Name of clinic where appointment is at:
*
Name of town the clinic is located:
*
Date of the appointment:
*
-
Month
-
Day
Year
Date
Time of the appointment:
*
Hour Minutes
AM
PM
AM/PM Option
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Submit
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