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Booking Form
(About You)
* Title:
* First Name:
* Surname:
* Email:
* Mobile Phone:
* Daytime Phone:
* Address Line 1:
Address Line 2:
* Town or City:
* Postcode:
* Country:
(Other Person Travelling with you)
Name of Passenger 1:
Age of Passenger 1 if under 18:
Name of Passenger 2:
Age of Passenger 2 if under 18:
Name of Passenger 3:
Age of Passenger 3 if under 18:
Name of Passenger 4:
Age of Passenger 4 if under 18:
Any other Information:

Maximum remaining characters: 500
* Which Campervan would you like:
* Holiday Start Date:
* Holiday Return Date:
(Extras)
Awning 50:
Sleeping Bags and Mats 10:
Bike Rack for 2 Bikes 10:
Bike Rack for 4 Bikes 20:
Porta Potti and Tent 10:
Sat Nav 20:
Damage Excess Reducer 10 per day:
Bedding per person 10:
Towel Packs per person 5:
External Gas BBQ 15:
(Details we need for your insurance Main Driver Details)
* Name:
* Occupation:
* Date of Birth:
* Age:
* Driving Licence Number:

Maximum remaining characters: 200
* Valid From:
* Issuing Authority:
* Have you been involved in any motoring accidents in the last 3 years:
If Yes How many:
* In the past five years have you been convicted of any motoring offences or had your licence endorse:
If yes list the dates the offence code eg SP30 the amount if you were fined and penalty points:

Maximum remaining characters: 500
Do you require an additional Driver:
(Transfers If you want us to pick you up from airport or train station please give details in the)
Transfers:

Maximum remaining characters: 400
(Terms and Conditions)
* I accept the terms and conditions:
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Telephone

+44 (0) 1484 600 303

Mobile

+44 (0) 7512411633

Email

kath@kgcampervanhire.com