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Fax Booking Please follow the steps below to ensure that we get everything that is needed for a successul booking. If you have any problems Contact Us. Once completed please PRINT out and FAX to +64 3 359 4132 or send by mail (bold required) Your name Your e-mail Email addresses must be included and correct to receive a response Quotation Number Q- (if applicable)   Address City Address2 Country State Zip Phone Fax Driver's licence No Country licence issue Date licence issue Expiry date Date of birth   Vehicle Hi-Top Budget Camper 01 02 03 04 05 06 07 08 09 10     Bond Waiver Insurance Yes No $12 per day Please note that additional insurance is completely optional and can be decided upon collection of your vehicle.     No of Adults 01 02 03 04 05 06 07 08 09 10 No of Children 01 02 03 04 05 06 07 08 09 10   Accessories Outside BBQ $50 Snow Chains $45 Colour TV $50 High Chair $25 Child Seat $25 Porta Cot (foldable) $40 Booster Seat $25 Solar Shower $15 Boogie Board $10 Recovery Kit (4WD bookings only) $75 Chilly/Eski Bin $10 Awning Kit (4WD bookings only) $12 per day Outdoor Table $15   1 2 3 4 5 6 Outdoor chair $5 ea     Start Location Auckland Christchurch Finish Location Auckland Christchurch Pick up Time 8:00am 8:30am 9:00am 9:30am 10:00am 10:30am 11:00am 11:30am 12:00pm 12:30pm 1:00pm 1:30pm 2:00pm 2:30pm 3:00pm 3:30pm 4:00pm 4:30pm 5:00pm Drop off Time 8:00am 8:30am 9:00am 9:30am 10:00am 10:30am 11:00am 11:30am 12:00pm 12:30pm 1:00pm 1:30pm 2:00pm 2:30pm 3:00pm 3:30pm 4:00pm 4:30pm 5:00pm Flight #   Start Date Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Jan (1) Feb (2) Mar (3) Apr (4) May (5) Jun (6) Jul (7) Aug (8) Sep (9) Oct (10) Nov (11) Dec (12) Year 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Finish Date Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Jan (1) Feb (2) Mar (3) Apr (4) May (5) Jun (6) Jul (7) Aug (8) Sep (9) Oct (10) Nov (11) Dec (12) Year 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015   Please enter any special requests or comments Credit card details are required to confirm bookings Name On Card Credit Card Type Visa Mastercard Credit Card Number Expiry Month / Year Jan (1) Feb (2) Mar (3) Apr (4) May (5) Jun (6) Jul (7) Aug (8) Sep (9) Oct (10) Nov (11) Dec (12) / 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015   I have read and understood Budget Campers Terms & Conditions

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