Each Participating Adult Must Complete This Form

Adult's Name *

First Name

Last Name

Phone *

Country

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Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

How Did You Hear About Us? *

Google

Word of Mouth

Yelp

Returning Customer

Other

I am aware of Replacement/Abandoned/and Damage Costs * *

Replacement costs SUPs (Stand Up Paddleboards) Est. Cost $525 Kayaks Est. Cost $475 SUP Paddle Est. Cost $100 Kayak Paddle Est. Cost $75 Adult Life Jacket Est. Cost $38 Youth Life Jacket Est. Cost $30 Lost or abandoned equipment will be billed $50 per hour for recovery time. All repair work (such as patching) will be billed $50 per hour plus materials. Bent paddles and badly damaged watercraft will be charged for replacement. It is solely the discretion of Little Jim Bridge Paddle Board & Kayak Rentals to determine if damaged equipment will be repaired or replaced at the renter’s expense. Prices are subject to change. A cleaning fee will be charged at $5 per item if equipment is returned dirty.

Yes

Rental Date *

MM

DD

YYYY