Type C2 Brest
All questions marked with
*
must be answered
Personal Details
Title:
*
Mr
Mrs
Miss
Ms
Dr
Rev
Full Name:
*
Tel No:
*
Fax No:
E-mail (ensure this is correct)
*
Drivers Age:
*
Your Country:
*
Travel Agent, Tour Operator Use Only
Agent ID:
Travel Details
Collect Date:
*
(HELP)
Collect time:
*
0900 to 1130 (Closed Monday AM)
1400 to 1630
Return Depot
*
Brest
Digne
Lyon
Paris
Marseille
Nice
Toulouse
Return Date:
*
(HELP)
Return time:
* ( July & August No Saturday Returns)
0900 to 1130 (Closed Monday AM)
1400 to 1630
Select a mileage option:
Limited mileage 150 Km per day
Unlimited mileage
Flight number, if known:
Will you cross any borders?
Party Details (Occupancy recommended up to 2 adults, maximum 2 adults and 2 children)
Adult Passengers (over 12 years)
*
1
2
Child Passengers (under 12 years)
1
2
Child(s) Age(s) - eg: 2,3,6?
Please state additonal drivers age(s)?
Extras - paid locally at pick up:
Do you require baby seat(s):
No
1
2
Do you require bedding set(s) - contains 2 sheets, 1 pillow, 1 pillow case and 1 blanket:
No
1
2
3
4
Do you require a folding picnic table:
No
yes
Do you require a bicycle rack (holds up to 3 adult bicycles):
No
yes
Do you require Collision Damage Waiver (CDW) reduces liability from a maximum of Euro 1800 to Euro 300 per occurance:
No
yes
Do you require PAI - 24 Hour Breakdown Insurance Assistance to passengers and vehicle in case of mechanical breakdown or non responsible accident. Towing costs, lodging (up to Euro 38 per person per day), other trasnportation or repatriation to departure location are covered by this insurance. Valid in countries listed in insurance green card. Note - Radio, air con, refrigerator, propane gas and 12 volt appliance malfunctions are not considered to be mechanical breakdown:
No
yes
Additional Comments:
