BLACKADAR BOATING, P.O. BOX 1170, SALMON, ID  83467

PHONE: (208) 756-3958   FAX: (208) 756-4452

Email:  blackadarboating@custertel.net

 

SHUTTLE INFORMATION AND RELEASE AGREEMENT

Please fill out completely and return with your keys and payment preferably at least 30 days prior to your shuttle.  If you send keys through the mail they need to be in a padded envelope: Keys have trouble in regular envelopes! 

Please call before you launch to insure that your vehicle keys were received.

 

Name _____________________________________ Daytime Phone # ________________________

 

Address _______________________________________ Cell Phone #________________________

 

City __________________________________ State ___________________ Zip ________________

 

I will be floating the ____________________River.  I will need ______________Vehicle(s) shuttled.

 

Pick-up my vehicle(s) at __________________________________ on (date) _____________________

 

Deliver my vehicle(s) to ___________________________________ on (date) ____________________

 

Vehicle(s) description including: make, model, color, license plate number and state, plus any

quirks your vehicle has.

 

VEHICLE DESCRIPTION(S)                                           SHUTTLE FEE       FUEL DEP              TOTAL

 

1. __________________________________________        _________      ________        _________

 

2. __________________________________________        _________      ________        _________

 

3. __________________________________________        _________      ________        _________

 

4. __________________________________________        _________      ________        _________

 

5. __________________________________________        _________      ________        _________

 

                                                                                                                        TOTAL _____________

 

PAYMENT: Cash _________ Visa _________ MasterCard _________ Check Number _________

 

CARD NUMBER ______________________________________ EXP DATE ____________

 

3-DIGIT SECURITY CODE (on back of card) ______________

 

I HEREBY STATE THAT MY VEHICLE(S) ARE PROPERLY INSURED AND THE

INSURANCE COVERS DRIVERS BLACKADAR BOATING MAY USE FOR THE

PURPOSE OF SHUTTLING SAID VEHICLE(S).

 

            SIGNATURE _______________________________________________________________