Please fill in the informations and send us your request:
first name:
last name:
address:
appartment:
city:
state:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
zip:
day phone:
evening phone:
fax:
email:
1st bike choice :
please choose a model
H-D V-Rod
H-D Dyna Super Glide
H-D Fat Boy
H-D Heritage Softail
H-D Heritage Springer
H-D Road King
H-D Electra Glide
H-D Ultra Classic
Honda Gold Wing
2nd bike choice :
please choose a model
H-D V-Rod
H-D Dyna Super Glide
H-D Fat Boy
H-D Heritage Softail
H-D Heritage Springer
H-D Road King
H-D Electra Glide
H-D Ultra Classic
Honda Gold Wing
pick-up date:
Month
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2008
2009
2010
2011
time:
what time?
8 a.m. - 9 a.m.
9 a.m. - 10 a.m.
10 a.m. - 11 a.m.
11 a.m. - 12 p.m.
12 p.m. -1 p.m.
1 p.m. - 2 p.m.
2 p.m. - 3 p.m.
3 p.m. - 4 p.m.
4 p.m. - 5 p.m.
5 p.m. - 6 p.m.
drop-off date:
Month
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2008
2009
2010
2011
time:
what time?
8 a.m. - 9 a.m.
9 a.m. - 10 a.m.
10 a.m. - 11 a.m.
11 a.m. - 12 p.m.
12 p.m. -1 p.m.
1 p.m. - 2 p.m.
2 p.m. - 3 p.m.
3 p.m. - 4 p.m.
4 p.m. - 5 p.m.
5 p.m. - 6 p.m.
rental hours:
how many hours?
24 hours
8 hours
6 hours
twilight
how did you hear about us?
Please tell us...
Newspaper
Flyer
Radio Station
Internet
Friend
Other
I posesses a valid Motorcycle license/endorsment; I affirm that I am at least 21 years old; I understand a $50.- per day deposit is requested to hold my reservation.
comments:
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