Blue Travel, Inc.    -    RESERVATION FORM    -    Road Bear RV
            Please fax to USA Toll Free: 1-877-605-6888 or
   United Kingdom: +44-208-711-5331  |  Germany: +49-3222-690-6222
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CUSTOMER ADDRESS:                                        (please print)
                :  ___ Mr.   ___ Mrs.
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      Last Name:  _____________________________________________________
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     First Name:  _____________________________________________________
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         Street:  _____________________________________________________
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           City:  _____________________________________________________
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     State, ZIP:  _____________________________________________________
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        Country:  _____________________________________________________
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 Tel +Area Code:  _____________________________________________________
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 Fax +Area Code:  _____________________________________________________
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         E-Mail:  _____________________________________________________
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PAYMENT:
      Card Type:  __ MasterCard  __ VISA   valid until:  ______________
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                  __ American Express + ID ____________________________
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    Card Holder:  _____________________________________________________
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Full Cardnumber:  _____________________________________________________
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This is a legally binding reservation request and I authorize 
Blue Travel to disclose my personal information to Road Bear RV.
I give permission for Road Bear RV to charge my credit card accordingly
with the appropriate hire costs, including all items marked below. 
I acknowledge that I am the authorized card holder of this account and
agree to abide by the published Terms and Conditions.
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RESERVATION:
     Vehicle Type:  _____________________   Mileage estimated: ________
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  Pickup Location:  _____________________   Date: _____________________
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Drop off Location:  _____________________   Date: _____________________
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  Number in Party:  ___   Convenience Kits :  ___   SLI Insurance:  ___
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 Transfer Request:  ___________________________________________________
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ADDITIONAL COMMENTS:
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City and Date                        Signature