Car Rental Waiver Form
Car Rental Waiver Form
Please complete this form to confirm your car rental booking and select optional waivers for insurance and liability coverage.
Renter’s Information
Name
Phone number
Driver’s License Number
Rental Agreement Number
Rental Details
Vehicle Model
Rental Start Date
Rental End Date
Waiver Options
|
Option |
Description |
Cost (per day) |
Selection |
|---|---|---|---|
|
Collision Damage Waiver (CDW) |
Protects against vehicle damage in an accident. |
|
|
|
Personal Accident Insurance (PAI) |
Covers medical expenses in case of an accident. |
|
|
|
Theft Protection Waiver (TPW) |
Limits liability if the vehicle is stolen. |
|
|
Acknowledgment and Signature
By signing, you acknowledge that you have read, understood, and agreed to the terms and conditions of the rental and waiver options.
Renter
Name:
Date:
Thank you for submission!
We appreciate you taking the time to submit.
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