Celtic Camper Company Campervan Booking Form

Campervans4fun - Hire Booking Form

First Driver’s Name: …………………………………………………………………

Destination……………………………………….……………………………………

Additional Driver(s) (£25 per driver)

Name: ……………………… Driving Licence No: ……………………………………

Number of adults: ……. Number of children: ……. Age of children: ….…………

Hire period:

FROM / TO
Short Weekend - Friday Noon to Sunday 7pm
Long Weekend - Thursday Noon to Tuesday Noon
One Week
Two Weeks

Please select your chosen van:

The White One - 4 Birth; 4 Seats;
The White One 2 - 4 Birth; 4 Seats
The Green Jeany -4 Birth; 4 Seats
Silver Surfer - 5 Birth; 5 Seats
Two's Company - 2 Birth; 2 Seats
The Blue Wonder - 5 Birth; 5 Seats

You can collect your van from 13.00PM and must return it by 12.00

All campervans come with: Cutlery for 4 and a canister of camping gas

Extras :-

Awning required? YES / NO?
Cycle rack required? (Max 2 Cycles) YES / NO?
Deck chairs required? (2 x adult chairs) YES / NO?
Hamper with crockery for 4: YES / NO?
Breakfast bundle (tea/coffee/milk/eggs/bacon) £20 YES / NO?

Any Special Requirements?

……………………………………………………………………………………………

I understand that this is a non-refundable deposit I have read
and I agree to the Terms and Conditions of booking and hire:

Signed: ………………………………………… Date: ………………………..

Where did you hear about us? Advert/Search Engine/Word of Mouth/Other

Please specify where you saw us if advertising/article or which Search Engine?

………………………………………………………………………………………….

Insurance Booking Form – a form to be completed by the First Driver

Please note that we cannot release any of the campervans without sight of both parts of your Driving License, passport and another form of ID – e.g. a recent household bill. Please remember to bring these with you.

Name: ………………………………………….……. DOB: ………………………

Address: ………………………………………………………………………………..

…………….……………………………………………Postcode: …………………….

Tel (Home): ……………….. (Mobile): …………………Email: ………………………

Driving Licence Number: …………………………………………………………

Occupation: …………………………

Date Driving Test Passed: ………………. Issue date of Licence: ………………..

Licence issued in which country? : …………………

1. Accidents in the last 3 years? Yes/No

If so, please list incident type, fault and any conviction: …………………………………………………………………………………………………………………………………………………………………………………………………………

2. Any physical or mental conditions which may interfere with your ability to drive?

These could be stroke/deafness/heart condition/diabetes/loss of limb/loss of sight

in an eye/epilepsy: Yes/No If so, please list: …………………………………………………………………………………………………………………………………………………………………………………………………………

3. Have you ever been convicted of any motoring offences? Yes/No

If so, please list the offence code, date, fine and points (as indicated on your Driving Licence)

......

……………………………………………………………………………………………………

Please note that answers to these questions may not prohibit you from hiring a vehicle but for insurance purposes you must declare ANY endorsements, motoring accidents, or physical or mental conditions.