Short term gear hire form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Gear Hire PolicyAvailable on the AUCC website here
I have read and understood the gear hire policy
4
Requested Gear
Kayak
Spray Skirt
Helmet
PFD
Paddle
Participation in Rafting
5
Specify kayak
6
River(s)
7
Section(s)and/or grade(s)
8
Date you would like to pick up gear
Date
Year
Month
Day
9
Date you will return gear
Date
Year
Month
Day
10
Card Payment* This field is required.Accepted Cards: Visa, MasterCard, AMEX. Please only select one option.
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My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costNZD
Non-Member Raft SeatPer day
$40.00NZDEdit
Back
Rafting SeatPer day
$20.00NZDEdit
Back
1
1
2
3
4
5
6
7
Quantity
KayakPer day
$10.00NZDEdit
Back
1
1
2
3
4
5
6
7
Quantity
GearPer day
$5.00NZDEdit
Back
1
1
2
3
4
5
6
7
Quantity
Total cost $0.00NZD
First Name
Last Name
11
Additional RemarksDescription, Intentions, Memes, Banter, and or other
Should be Empty: