RESERVATION APPLICATION

I have read and understand the Policy Requirements Yes

Renter's Name Phone

E-mail Cell Phone

Address: City: State: Zip

Employer: Ph# Position:

Address: City: State: Zip

PERSONAL REFERENCE

Name: Home Phone # Work Phone #

Address: City: State: Zip

TRIP INFORMATION

Drop off Date: MM/DD/YEAR Time: AM PM

Pick Up Date: MM/DD/YEAR Time: AM PM

TRAILER SIZE REQUESTED

17 Foot Trailer

25 Foot Trailer Bunkhouse

26 Foot Trailer Bunkhouse

27 Foot Trailer Bunkhouse

31 Foot 5th Wheel Luxury Trailer

AUTO INSURANCE

Auto Ins. Co. Agent Name/Phone#

Generator rental is available days @ $ 35.00 per day

PICK UP AND DROP OFF

Drop off designated Campground

Pick up designated campground The charge for this is $ 1.30 a mile.

Referral Source:

AUTHORIZED RENTERS - REQUIRED FOR ANY DRIVER

# 1 Full Name: Age: Birth Date: MM/DD/YEAR

License #: State: Exp. Date: MM/DD/YEAR

RESERVATION DEPOSIT $ 300.00 WHICH IS DEDUCTED FROM THE RENTAL BALANCE AND SECURITY DEPOSIT $ 500.00 WILL BE AUTHORIZED AT TIME OF DEPATURE.

It is necessary for this authorization to be read and signed. Return by e-mail or fax to confirm the services to be charged to your $2000 card. Whether you are using a credit card or not, an open credit card authorization is taken for all rentals. Please have your credit card available at time of departure. Canyonlands will upon receiving your reservation form charge your credit card for the $ 300.00 reservation deposit and it will be deducted from the rental. The rental balance of your trailer rental will be charged before leaving with the trailer for drop off to the designated Campground. Canyonlands will not charge your credit card for extra charges unless damages are present when the RV is picked up.

Charges that will be deducted from the $ 500.00 Security Deposit, or other costs that exceed the security deposit relating to your RV rental, would be to fill up propane, fill up generator to pre-rental use (if you rented a generator), damages to the interior or exterior or the awning of the trailer, or if the interior is not cleaned as you received it, or if you have extra days of rental, a $2000 deductable will apply if involved in any accident (per accident), or a late charge of $ 25.00 per every 15 minutes if the driver is kept waiting later then your scheduled time. NO SMOKING OR NO ANIMALS ARE ALLOWED IN THE TRAILER. THE SECURITY DEPOSIT IS NON REFUNDABLE IF EVIDENCE OF SMOKING AND OR HAVING ANIMALS IN THE TRAILER.

Be aware that the reservation deposit of $ 300.00 is not refundable, if rental is canceled 30 days or less prior to the departure date. All cancellations are charged $100.00 cancellation fee. PLEASE DOWNLOAD THIS PAGE FOR YOUR RECORDS.

Credit Card Holder Name: Home Phone:

Address: City: State: Zip Code:

I , with my signature, as it appears on my credit card, authorize Canyonlands RV, LLC LLC. To charge my credit card for the reservation deposit only. The remaining balance will be charged before departure with the Trailer to the designated campground, unless otherwise authorized by the customer. "

The Above information is true and correct to the best of my knowledge, and I have read and understand the above RESERVATION AND DEPOSIT INFORMATION.

Renters Signature: Date: MM/DD/YEAR

We are unable to accept credit cards via our website, but we are happy to accept your reservation deposit via telephone. Once you have submitted this form, please call us to confirm that we have recieved this, and we will take your information at that time. We look forward to assisting you!

WE WILL CHARGE YOUR CARD FOR THE FULL AMOUNT ON THE DAY BEFORE YOUR RENTAL.

Submit Fom

THE CREDIT CARD USED MUST BE IN THE RENTERS NAME THE SAME NAME THAT WILL BE USED ON THE SIGNATURE OF RENTAL CONTRACT.