I Hereby authorize and request AFFORDABLE SHUTTLES to drive my vehicle to the location
shown below. I am the owner or the authorized driver and carry the insurance shown. I agree that my vehicle is being shuttled as a convenience to me and I understand that the roads are
narrow, with gravel surfaces and much traffic. Because of this I understand that there is a risk of damage to my vehicle. I hereby assume that risk and release and agree not to sue AFFORDABLE
SHUTTLES, its agents or employees from any and all damages or liability which may result from their driving or parking my vehicle, whether or not caused by their negligence. Thank you.
Please supply the following information in the fields below.
Print out and leave in vehicle.
___ NO ___
Lock Vehicle Yes ____No_____
Shuttle vehicle to:
_______________________ Day:_______ Date:__________ Time:________ Gas Level:
Condition of vehicle:
Put in point: ________________
License plate Number of vehicle to leave keys in at
EXCATLY to find KEY
at TAKE-OUT: ________________________________________
* Note: Example: Back Bumper, Gas Tank or
inside (if you have spare key)
Insurance Co.: _____________________ Policy#: _______________________
Vehicle Owner/Authorized Driver/Date: