Blue Travel, Inc.    -    RESERVATION FORM    -    KEA Campers
            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)
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                :  ___ 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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    Phone Number:  _____________________________________________________
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      Fax Number:  _____________________________________________________
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         *E-Mail:  _____________________________________________________
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PAYMENT:
       Card Type:  ___ MasterCard      ___ VISA       ___ Diners Club
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                   ___ American Express    _______________________ ID
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    *Card Holder:  _____________________________________________________
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*Full Cardnumber:  _____________________________________________________
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*Expiration Date:  _______________ (Month / Year)
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This is a legally binding reservation request and I authorize
Blue Travel to disclose my personal information to KEA Campers.
I give permission for KEA Campers to charge my credit card accordingly
with the appropriate hire costs. I acknowledge that I am the authorized
card holder of this account, have read the Terms and Conditions and
agree to abide by them.
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RESERVATION:
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     *Vehicle Type:  ___________________________________________________
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*No. of Passengers:  ___   *Standard Rate: ___ *All Inclusive Rate: ____
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*  Pickup Location:  _____________________     *Date: __________________
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*Drop off Location:  _____________________     *Date: __________________
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ADDITIONAL COMMENTS:
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City and Date                        Signature