Blue Travel, Inc.  -  RESERVATION FORM  -  EagleRider Motorcycle Rental
            Please fax to USA Toll Free: 1-877-605-6888 or
   United Kingdom: +44-208-711-5331  |  Germany: +49-3222-690-6222
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CUSTOMER ADDRESS:                                        (please print)
                :  ___ Mr.   ___ Mrs.
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      Last Name:  _____________________________________________________
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     First Name:  _____________________________________________________
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         Street:  _____________________________________________________
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           City:  _____________________________________________________
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     State, ZIP:  _____________________________________________________
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        Country:  _____________________________________________________
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   Phone Number:  _____________________________________________________
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     Fax Number:  _____________________________________________________
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         E-Mail:  _____________________________________________________
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PAYMENT:
      Card Type:  __ MasterCard   __ VISA  Valid Until:  ______________
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    Card Holder:  _____________________________________________________
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Full Cardnumber:  _____________________________________________________
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This is a legally binding reservation request and I authorize
Blue Travel to disclose my personal information to EagleRider. 
I hereby confirm my rental dates and authorize EagleRider to charge all
rental costs including the sales tax to the credit card listed above. 
I acknowledge that I am the authorized card holder of this account
and agree to abide by the Terms and Conditions as published at
www.blue-travel.net/eaglerider/
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RESERVATION:
Motorcycle Model:  _____________________   Free Miles: _______________
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 Pickup Location:  _____________________   Date: _____________________
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 Return Location:  _____________________   Date: _____________________
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Transfer Request:  ___________________________________________________
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ADDITIONAL COMMENTS:
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City and Date                        Signature