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Section 1 - Launch & Takeout
Launch Location:
Launch month:
Launch Date:
AM/PM:
Take Out Location:
Take Out month:
Take Out Date:
AM/PM
Section 2 - Billing Information
Name:*
Billing Address:*
Phone:*
-
E-mail:
Emergency Contact Name:
Emergency Contact Phone:
-
Section 3 - Vehicle Information
Plate No:*
Make:*
Fuel Deposit:
Lock info:
Spare Tire Lock:
Trailer Lock:
Comments:
Vehicle year:*
Model:
Fuel Deposit amount:
State:
Color:
Section 4 - Trip
Trip Leader Name:
Key Location Launch:
Key Code:
Other:
# of Cars In Your Party:
Key Location take out:
Insurance/Registration Info Location:
Section 5 – Vehicle

Permission is hereby given to drive the described vehicle as arranged. This vehicle is covered by public liability and property damage insurance that will cover this vehicle and the shuttle driver. The vehicle has at least $100 deductible collision and comprehensive insurance. If it does not, I understand that I am liable for charges resulting from any deficiency in coverage.

I understand that the roads driven may be rough and poorly maintained. I will not hold Hells Canyon Shuttle, Inc. responsible in any way for damage done to the described vehicle while en route or parked.

If my vehicle (or trailer) is or becomes inoperable, unsafe, or unlawful to operate for any reason (including but not limited to: engine or mechanical failure, security system malfunction, ignition or gas cap key problem, no spare tire or tools, expired registration), I authorize Hells Canyon Shuttle, Inc. to exercise the option on my behalf that I have selected below.

I agree to pay for all reasonable expenses upon receiving my vehicle. Once my trip has begun, I understand the shuttle fee is non-refundable.
If my trailer or vehicle becomes inoperable:
Section 6 – Payment
Shuttle Payment:
Payment Location:
Shuttle Quote:
Please call us at 800-785-3358 or 800-785-7192 for reservation number.
Word Verification: