Mr/Mrs/Miss/Ms Full Name ................................................................................... Address ................................................................................... ................................................................................... Postcode ................................................................................... Email ................................................................................... Date of Birth ................................................................................... Occupation ................................................................................... Home Tel No ................................................................................... Mobile No ................................................................................... Full Driving License No ................................................................................... Years Held ................................................................................... Endorsements YES / NO Date: ............................. Offense Code: ............................. Points: ............................. PLEASE LIST SAME DETAILS FOR ANY ADDITIONAL DRIVERS ON A SEPERATE SHEET No. of people in party .................. Children .................. Children's ages .................. Lifestyle Leasing Reservation Number ................................................................................... For touring Uk / Europe Period of Hire/Dates To - ..................... From - ...................... Countries to be visited ................................................................................... ................................................................................... We strongly advise you to take out insurance cover for personal accident and personal item cover I have read and agree to the terms and conditions of hire and pay the sum of £150.00 as a booking deposit which I understand is not refundable in the event of cancellation. Please sign in the space provided below Signed ................................................................................... Date ...................................................................................