Dubbelju Reservation Form

SECURED ONLINE RESERVATION FORM

For all dates: Please spell out the month, i.e., July/28/1972

1. I have learned about Dubbelju from:

2. Have you rented from us before?

yes

no

RIDER

3. Full Name

4. Company Name/Tour Co (Optional)

5. Address (street & appt. #)

6. City

7. State/Country

8. Postal Code

9. E-mail address

10. Confirm e-mail address

11. Phone

12. Alternate phone

13. Driver's Licence Number

14. Expiration date (month/day/year)

A second form of ID (for address verification) is required if driver's license was issued in a state other than motorcycle rider's current residence.

15. State issued

16. Date of Birth (month/day/year)

Select the motorcycle wanted

17. Motorcycle Model

I will accept similar model if desired model is not available:

18. Similar Motorcycle

yes

no

19. Pick up date (month/day)

20. Pick-up time (9 am to 6 pm)

21. Drop-off date (month/day)

22. Drop-off time (9 am to 6 pm)

23. Pick up location (if not San Francisco)

24. Drop-off location (if not San Francisco)

RESERVATION DEPOSIT

25. Deposit amount

BILLING

26. Credit Card No.

27. Expiration date (month/year)

Security Code: These numbers are used by your credit card company to help prevent fraud. The American Express code is a 4 digit number on the front of card; Visa, Mastercard, and Discover codes are 3 digit numbers located on the back of card.

28. 3 digit code (4 digits for AXpress)

BILLING ADDRESS (If different from mailing address)

29. Address (Street and Appt. #)

30. City

31. State/Country

32. Postal Code

I authorize a charge of $300 per motorcycle (We require a $50 deposit for a one or two day rentals), plus all one way charges for the reservation of the motorcycle indicated above (If this applies)

33. Deposit Agreement

I agree

CANCELLATION AND REFUNDS (Please read carefully)

34. Cancellation agreement

I/We understand that deposits for any reservation of motorcycles for which DUBBELJU receives notice of cancellation at least 31 days before pick up date of the motorcycle will be subject to a fee of 10% of the rental price, but not less than $150, as liquidated damages. Deposit balance may be put towards future rentals (we do not give refunds). If a cancellation is received 30 days or less prior to rental date, 50% of the rental price, but not less than $300 will be forfeited; if received on day of departure or no-show, 100% of the rental price will be forfeited as liquidated damages. Modifications to reservation are subject to a $30 handling fee. Hotel and other reservation deposits will be refunded based on the amounts recoverable from the hotels and other contractors.

Damage Deposit: A $2500 security damage deposit is required to cover the cost of damages to the motorcycle and must be deposited at the rental center when signing for the rental motorcycle. Motorcycle renter must be the cardholder. The deposit can be reduced by accepting the CDW and is returned in full when no accident occurred and the undamaged motorcycle is returned.

As a Motorcycle rider, I promise that I am experienced and responsible and in good health with a valid motorcycle license and at least 25 years old, and I have a minimum of 2 years experience in the use and operation of a high performance motorcycle of similar size to the size I wish to rent. As a Motorcycle rider or passenger I am aware that traffic, road conditions, weather and other variables can enhance the inherent risk of motorcycling. I/We fully accept these risks. In signing this reservation form I hereby agree to accept the terms and conditions above.

35. Cancellation Agreement

I agree

Would you like to receive Dubbelju's quaterly newsletter? We will keep you posted on the latest additions to our fleet, the coolest rides and places to stay, and all specials on our rentals. WE WILL NEVER SHARE YOUR E-MAIL ADDRESS WITH OTHER COMPANIES.

36. Newsletter and Specials

yes

no

If you have any questions regarding your reservation or motorcycle availability, please give us a call at 866 495 2774 (US only) or 415 495 2774.