BOOKINGS AND INSURANCE FORM

 

After submitting your details below a deposit of £100 will be payable via Payatrader to confirm your booking.

* Payatrader is a a fully accredited secure credit and debit card acceptance service that allows Plumtree Motorhome Hire to accept secure credit/debit card payments online.

IMPORTANT - Please note that this is a pre-request notification to book - A booking will NOT be confirmed until a deposit is paid, received and accepted
 
ENSURE THAT ALL THE FOLLOWING DETAILS ARE FILLED OUT CORRECTLY. FAILURE TO INCLUDE ALL DETAILS WILL DELAY YOUR APPLICATION
 
Choose Motorhome (required)

Swift Lifestyle 686 - 6 berth motorhome



Period you would like to book e.g. 1st June - 7th June

Full Name (required)

Full Address Including Poscode (required)

Email Address (required)

Mobile Telephone Number (required)

Date of Birth (required)

* I confirm that I am over 21 years of age and under 75
YES NO

Occupation (required)

Driver licence number (required)

* I confirm that I have held a full driving license for at least 2 years
YES NO

Please complete the DVLA license check form via this link www.viewdrivingrecord.service.gov.uk/driving-record/licence-number to obtain the code provided so we can complete a licence check.
Please enter the code you receive below. (A separate page will open to access the Driving Licence Information Form to obtain the code we require to perform a license check)



* I confirm that I am in good health. “Good Health” means that you have no mental or physical disabilities that would interfere with your ability to drive. For example (but not limited to) stroke/deafness/heart condition/diabetes/loss of limb/loss of sight in an eye/epilepsy.
YES NO

* I confirm that I am not taking drugs likely to affect my driving or drugs prescribed by a registered medical practitioner for treatment of drug addiction.
YES NO

PLEASE GIVE DETAILS OF ANY CONVICTIONS IN THE LAST 5 YEARS (If none state 'NONE')



Have you had more than one accident/claim within the last 3 years?
YES NO

PLEASE GIVE DETAILS OF ANY ACCIDENTS/CLAIMS IN THE LAST 3 YEARS



PLEASE GIVE DETAILS OF NAMES AND DATE OF BIRTH OF ALL PASSENGERS IN THE MOTORHOME (For insurance reasons)



Predicted Destination (If unknown type UNKNOWN)

PLEASE GIVE DETAILS OF ANY SPECIAL REQUIREMENTS



OPTIONAL EXTRA'S

Bike Hire - £20 per bike per week
YES NO

PLEASE CONFIRM YOU HAVE READ THE TERMS & CONDITIONS OF HIRE
YES NO