BLACKADAR BOATING, P.O. BOX 1170,  HWY 93 NORTH, SALMON, ID  83467

PHONE: (208) 756-3958                                                        FAX: (208) 756-4452            

EMAIL: blackadarboating@custertel.net

SHUTTLE INFORMATION AND RELEASE AGREEMENT

Please fill out completely and return with your keys and payment prior to your shuttle.  Keys sent through the mail need to be in a padded envelope: Keys have trouble in regular envelopes!  Please call before you launch to insure that your vehicle keys were received.

Name ______________________________________ Daytime Phone # _______________________

Address _______________________________________ Cell Phone # _______________________

City ___________________________________ State _________________ Zip ________________

Email Address_____________________________________________________________________

I will be floating the ______________________River.   I will need ___________Vehicle(s) shuttled.

Pick-up my vehicle at ____________ on (date) _______Deliver my vehicle to _________ on (date) ______

Vehicle(s) description including: make, model, color, license plate number and state, plus any quirks your vehicle has.

PAYMENT: Cash _____  Visa _____  MasterCard _____  Discover _____  Check Number ______

CARD NUMBER ___________________________________ EXP DATE ___________________

3-DIGIT SECURITY CODE (on back of card) ____________________

I HEREBY STATE THAT MY VEHICLE(S) ARE PROPERLY INSURED AND THE INSURANCE COVERS DRIVERS BLACKADAR BOATING MAY USE FOR THE PURPOSE OF SHUTTLING SAID VEHICLE(S).

SIGNATURE ______________________________________________________________