Blue Travel, Inc. - RESERVATION FORM - MOTURIS RV & Camping World Please fax to USA Toll Free: 1-877-605-6888 or United Kingdom: +44-208-711-5331 | Germany: +49-3222-690-6222 . CUSTOMER ADDRESS: (please print) : ___ Mr. ___ Mrs. . Last Name: _____________________________________________________ . First Name: _____________________________________________________ . Street: _____________________________________________________ . City: _____________________________________________________ . State, ZIP: _____________________________________________________ . Country: _____________________________________________________ . Tel +Area Code: _____________________________________________________ . Fax +Area Code: _____________________________________________________ . E-Mail: _____________________________________________________ . PAYMENT: Card Type: __ MasterCard __ VISA Valid Until: ______________ . __ American Express + ID ____________________________ . Card Holder: _____________________________________________________ . Full Cardnumber: _____________________________________________________ . This is a legally binding reservation request and I authorize Blue Travel to disclose my personal information to MOTURIS RV & Camping World. I give permission for MOTURIS RV & Camping World to charge my credit card accordingly with the appropriate hire costs, incl. all items marked below, the preparation fee and the sales tax. I acknowledge that I am the authorized card holder of this account and agree to abide by the published Terms and Conditions. . RESERVATION: Vehicle Type: _____________________ Free Miles: _______________ . Pickup Location: _____________________ Date: _____________________ . Drop off Location: _____________________ Date: _____________________ . No. of Passengers: ___ VIP Insurance: ____________ . Convenience Kits : ___ Baby Seats: ___ Mountain Bikes : __________ . Transfer Request: ___________________________________________________ . ADDITIONAL COMMENTS: . . . . ____________________________________ ___________________________________ City and Date Signature