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1General Information

2Documentation

3Payment Information

Last Name*
Last
Confirmation Number*
Email Address*
Cell Phone Number
Alternate Phone Number
Local Accommodations
Villa Name
Greeter Name
Phone Number
Name
Host Name
Phone Number

Driver's License Information
Name
First Last
Driver's License Number
Driver's License Expiration Date
MM slash DD slash YYYY
Issuing State
Date of Birth
Month
Day
Year
Driver's License Confirmation*
I will provide a physical, valid Driver's License at time of pick-up and accessible while operating Rental*
Are there any other drivers?
Additional Driver
Extra charge of $5 per day will be applied
First Last
Driver's License Number
Driver's License Expiration Date
MM slash DD slash YYYY
Issuing State
Date of Birth
Month
Day
Year
Car Insurance Information
How will you be providing insurance?
Upload Coverage Policy
Drop files here or

Max. file size: 300 MB.
Proof of Insurance
Drop files here or

Max. file size: 300 MB.
Example:
Example:
Car Insurance Company Name
Expiration Date
Month
Day
Year
Policy Number
Insurance Company Phone Number
Insurance Confirmation*
I will have a valid Insurance card at the time of pick-up and accessible while operating Rental*
If waived, proof of Insurance and verification of coverage in the US Virgin Islands, operating a 4x4 sports-utility vehicle is required. Renter(s) are liable for the full amount of the Rental. If Courtesy Car/Jeep Rental’s collision, personal accident, and liability insurance ($15 per day) is purchased, Renter’s liability is reduced to $1,500.
If waived, proof of Insurance and verification of coverage in the US Virgin Islands, operating a 4x4 sports-utility vehicle is required. Renter(s) are liable for the full amount of the Rental. Please note, if you wish to use the auto insurance offered by your credit card company, credit card companies usually require that you use the same credit card for the deposit and remaining balance of the Rental. If Courtesy Car/Jeep Rental’s collision, personal accident, and liability insurance ($15 per day) is purchased, Renter’s liability is reduced to $1,500.
Flight Information
Have you booked your flight?
Arrival Date
MM slash DD slash YYYY
Airline Name
Flight Number
Flight Arrival Time

: Hours

Minutes

AM/PM

Local Accommodations

Driver's License Information

Additional Driver

Car Insurance Information

Flight Information

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