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Date of Birth
Day
Month
Year
Do you suffer from any physical or mental defects that may have an impact on your driving?
Yes
No
Have you had any motor offences in the last 3 years?
Yes
No
Have you ever been refused motor insurance?
Yes
No
Have you had any motor accidents in the last 3 years?
Yes
No

We require a photo of the front and back of your driving license and 2 photos of utility bills proving address (matching driving license address).

If you have been involved in any incident involving either a third party or a passenger you must notify us immediately, failure to do so could result in legal action being taken against you - the hirer.


Limitations as to use: social domestic and pleasure purpose by the hirer/named driver(s) shown above. Business purposes by the hirer/name drivers shown above. Excluding racing, pace-making, reliability trial or speed testing and excluding use for hire or reward.


The owner agrees to let and the renter agrees to take on hire the vehicle upon and subject to the terms & conditions contained herein and listed separately a copy of which is available with this rental agreement. Statement of liability. I hereby acknowledge that during the currency of hiring agreement shall be liable as the owner of the vehicle let to me there under in respect of: (a) Any fixed penalty offence committed in respect of that vehicle under the Road traffic act 1991 including congestion charge penalties and alike. (b) Any excess parking charges which may be incurred of that vehicle and pursuance of an order under section 45 and/or 46 of the Road Traffic regulation act 1984.

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