Booking Form

This form will place a booking to rent an RV from Corona Motorhome Rentals Inc.. Complete all sections of the application, read the Terms and Conditions Agreement below, and check all the boxes signifying that you have read and agree with the terms outlined. Your reservation will be submitted to our Rental Department. The required fields are marked with *

 
How did you hear about us?
Last Name, First and M.I. *
Street Address *
City *
State *
Zip / Postal Code *
Country
Work Phone *
Home Phone
Cell Phone *
Email Address *
Date Needed *
  To   
Number in party *
Preferred Vehicle *
Destination *
Insur. Co, Phone # & Policy # *
Driver License # *
Expiration Date *
 
Renter's Employment Information
 
Employer *
Employer's Phone *
Employer's Address / City / Zip *
Years Employeed *
 
(Optional) Fill out only when renting a Trailer/Toy Hauler
 
Year & Make of Tow Vehicle
Model
Vehicle License #
Policy #
Agent Name
Phone #
 
Credit Card Information (Booking will not be complete without this)
 
Credit Card Type *
Credit Card Number *
Name on Card *
Expiration Date *
CVC # *
 
Additional Information
 
Nearest Relative *
Phone Number *
Quote number or additional notes *
 
Terms and Agreement
 
You must read the Terms and Conditions Agreement below, check all the boxes contained within this document signifying that you have read and agree to each item, select "I AGREE" and then click the "Submit" button. Please read these agreement carefully

 I have carefully read and agree to the terms and conditions stated above.
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