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Bicycle Rental/ Demo Form
Bicycle Rental Details
Bike Brand*

Bike Model

Bike Size

Date of Pickup:*

mm/dd/yyyy
Pickup Time:*

Half Day Rental $40
Full Day Rental/Demo $60
24 Hour Rental/Demo $75

Billing Information
First Name:*

Same name as on your card
Middle Initial:

Last Name:*

Address Line*

Where your statement is mailed
E-mail

City:*

State:

Country:*

Phone:

Postal Code:*

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