Contact information:
First name:
Last name:
Email address:	* required
Phone Number:	* required
Mailing address:
Reservation Information:
Rental Request:
Reservation Date:  Beach Cottage Delivery Address:	* required Beach Cottage Address
Best way to contact you:	Email address phone
I, for myself and any minor child for which I am parent, legal guardian or otherwise responsible, release the bicycle shop, agents, and employees from any liability for damage or injury to myself or any person or property resulting from negligence, adjustment, selection and use of this equipment.  I, understanding the inherent risk involved in using this equipment, accept the full responsibility for any and all damage or injury which may result.      I accept for use, as is, the equipment in good condition and accept the full responsibility for care of equipment while in my possession.  I will be responsible for the prompt replacement at full retail value of all rental equipment not returned or damaged, other than reasonable wear and tear, which results from the use of this equipment.       I agree to return rental equipment by agreed date in clean condition to avoid additional charges.  I understand the function of the equipment. I am 18 years of age or older.  I accept the terms of this agreement and responsibility for the above charges.
By Accepting, you agree to the above terms of the rental agreement I Accept the Terms I Do not Accept the Terms