South City Scooters - Online Waiver & Rental

Step 1: Adult Renter Information & Waiver

Full Name:

Phone Number:

Local Address (e.g., hotel, B&B):

Email Address:

Please read the following agreement carefully. You will be asked to initial key sections.

Helmet Use Agreement (Section 2): Initial here

Express Assumption of Risk (Section 3B): Initial here

Waiver of Liability and Release (Section 4): Initial here

Indemnification (Section 5): Initial here

Credit Card Authorization (Section 6): Initial here

Number of Minors (under 18) riding with you:

I have read, understood, and agree to all terms and conditions of the E-Bike Rental Agreement, Express Assumption of Risk, Waiver of Liability, Indemnification, and Credit Card Authorization as initialed above.

Step 2: Minor Renter Information & Waiver

Please read the following agreement carefully. You will be asked to provide information and initials for each minor.

Parent/Guardian Full Name (Confirming for Minors):

Relationship to Minor(s):

I, as the Parent/Guardian, have read, understood, and agree to all terms of the Parental/Guardian Consent, Indemnification, and Acknowledgment of Risks for Minor E-Bike Rider for all minors listed above, and confirm my initials where required.

Step 3: Payment Details

Cardholder Name:

Card Number:

Expiration Date (MM/YY):

CVV:

Billing Zip Code:

Pay with Bank Account (ACH)?

Reservation Confirmed!

Thank you for your reservation with South City Scooters.

A confirmation email has been sent to you. We look forward to seeing you!

South City Scooter Sales
St. Louis, Missouri
314.000.0000

South City Scooters | Waiver & Rental

Step 1: Adult Renter Information & Waiver

Step 2: Minor Renter Information & Waiver

Step 3: Payment Details

Reservation Confirmed!