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.


Vehicle License#:  ____________________    Make: _____________________ Color:  ____________

Trailer: ____________________________  Yes ___ 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 TAKE-OUT: ___________________________

* Where
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:    ___________________________________________________________







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