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Mobility Scooter Rental
Scooter Rental
1
Dates
2
Renter Details
3
Payment
Start Rental Date
(Required)
MM slash DD slash YYYY
This is the date we will drop off the scooter
End Rental Date
(Required)
MM slash DD slash YYYY
This is the date where we will pick up the scooter. We typically pick up in the morning.
Hidden
Number of Days In Rental
Please enter a number from
1
to
365
.
Scooter Rental
Price:
$0.00
Scooter Rental
Price:
$0.00
Scooter Rental
Price:
$0.00
Scooter Rental
Price:
$0.00
Scooter Rental
Price:
$0.00
Pickup / Delivery Options
(Required)
$0.00 I will pick up the scooter at 7792 Broadview Rd, Parma, OH 44134
$25.00 Delivered 5 miles of Parma, OH
$50.00 Delivered 25 miles of Parma, OH
You can pick up for free, or have it dropped off for a fee.
Delivery Fee
Price:
$0.00
Summer Savings 3 Day Rental
Price:
Summer Savings 5 Day Rental
Price:
Total Cost
Pickup/Dropoff Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Dropoff Location
(Required)
Street Address
Address Line 2
City
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District of Columbia
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Renter's Name
(Required)
First
Last
Who will be receiving the scooter at the pickup/dropoff location?
(Required)
Myself
Somebody else
Who will receive the scooter?
(Required)
First
Last
Email
(Required)
Phone
(Required)
Credit Card
(Required)
Cardholder Name
Card Details
Consent
(Required)
I agree to the rental policy.
download rental policy