ELECTRIC SCOOTER,PRIDE, SHOPRIDER, NO BOUNDRIES, HARMAR,Electric Scooters,Power Chair,Lifts and Carriers,Lift Chair,Stair Lift,Ramp,Accessories,Electric scooter,Three Wheeler scooter,Four Wheeler scooter,All Scooters,florida

Rental Products

You can easily reserve your scooter by completing the following on-line reservation form, or contact us directly to set up your rental.

Each scooter rented requires its own reservation.

If for some reason you have any difficulty or would prefer to speak with us directly to make your reservation, please call toll free 1 (800) 820-3576 in the US or 1 (727) 816-9772.

Scooter Renter Name *

Person Name Holding Hotel/Accommodation Reservation where we will be delivering Scooter (*)

Street billing address of scooter renter credit card that will be used (*)

City

State

Zip

Country

Home Phone

Cell Phone

Email Address (*)

How did you hear about our company

Where will you be staying in Tampa Bay area/where will we be delivering the scooter: Accommodation Name (*)

Address

City

Phone No.

Please choose Equipment Needed (*)

Renters Arrival Date Into Tampa Bay Area

Renters Approximate Arrival Time Into Tampa Bay Area

Date the client wants the scooter delivered to begin use/rental (*)

Time the client wants the scooter delivered to begin use/rental (*)

Hour: Minute:

Date the client wants the scooter picked up to end use/rental (*)

Time the client wants the scooter picked up to end use/rental (*)

Hour: Minute:

Mobility Products	Weight Capacity	Days Renting	Cost

Delivery & Pick Up :
7% Sales Tax
Total

Riders Height " (*)

Riders Weight: lbs (*)

lbs

Travel Agent's Email Address

Travel Agent's Code

Other important delivery and information

Credit Card being Used

Visa	American Express
Master Card	Discover

Credit Card Number (*)

Card Holders Name (*)

Expiration Date (*)

Security Code (*)

(The last three digits located on the signature strip on the back of your MasterCard, Visa or Discover card or the four digits above your card number on the front of your American Express)

I authorize the total rental Amount to be charged to the above credit card 24 hours before equipment rental begins. I understand I am fully responsible for the scooter during the rental period and any damage or loss incurred while in my possession.

I may cancel my rental and receive a full refund up to 12 hours prior to my arrival and must call in my cancellation to Scooter Direct – Scootogo.com at toll free 1 (800) 987-6791 or for international callers to 1 (727) 816-9772

By checking this box, renter agrees to the Rental Agreement and Waiver of Liability and Hold Harmless Agreement