Please
circle preferred Size and Model below :
 |  |  |  |
Small
Mobility Scooter Model:Prism 3 | Small
Mobility Scooter Model:Prism 4 | Medium
Mobility Scooter Model:Neo 4 | Large
Mobility Scooter Model:Regatta 4 |
 |  |  |  |
Powerchair Model:Enigma Energi | Manual
Wheelchair Model:MW Chair | Electric
Wheelchair Model:Powerstroll | Walker
/ Stroller Model:Rollator |
Your
Details
Physical
Difficulty: | ___________________________________________________________________ |
Height: | ___________________________________________________________________ |
Weight: | ___________________________________________________________________ |
*Name: | ___________________________________________________________________ ___________________________________________________________________ |
*Email
Address: | ___________________________________________________________________ |
*Telephone
Number : | ___________________________________________________________________ |
*Home
Address: | ___________________________________________________________________ ___________________________________________________________________ |
*Postcode: | ___________________________________________________________________ |
*Country: | ___________________________________________________________________ |
Flight Details
*Outward
Flight No: | ___________ | *Depart
Airport: | _____________ | *Arrival
Airport: | _______________ |
*Arrival
Date: | ___________ | *Depart
Time: | _____________ | *Arrival
Time: | _______________ |
*Return
Flight No: | ___________ | *Depart
Airport: | _____________ | *Arrival
Airport: | _______________ |
*Departure
Date: | ___________ | *Depart
Time: | _____________ | *Arrival
Time: | _______________ |
Accommodation Details
| *Hotel/Aptartment/Villa/Resort Address : | ____________________________________________________ |
*Passport
Number : | __________________________ |
Hire
Cost: | __________________________ |
Delivery
Cost : | __________________________ |
Sub
Total : | __________________________ |
Vat
@ TRNC Rate of 16% | __________________________ |
Total
: | __________________________ |
Security
deposit (Refundable On safe undamaged return) | __________________________ |
All Bookings are in accordance with the following terms & conditions of hire.
1 - Additional VAT will be charged at the local rate of 16 % , no exemption in TRNC.
2 - Delivery is free within 10 miles of Kyrenia & 15p / mile thereafter on delivery & pickup return.
3 - A normal security deposit of £100 is added to your bill, refundable on safe complete undamaged return.
4 - Your safety is your responsibility and ENABLE HOLIDAY MOBILITY cannot be held responsible for any injuries you incur upon yourself.
5 - Client must be available to take delivery and return in person.
6 - All payments in cash only please at time of delivery, no cheques or credit cards.
Call us now on Tel: 0090 542 872 51 98