Moped, Scooter and Bicycle Rental form

Call 866-296-1625 or Email info@mopedhospital.com

Call 866-296-1625
"Key West's Finest"
Email info@mopedhospital.com

The Moped Hospital
601 Truman Ave.
Key West, FL 33040
Phone: 866-296-1625
Fax: 305-292-7679
E-mail: info@mopedhospital.com

Last revised June 19, 2008.

Name
Phone
Cell Phone
E-mail
Vehicle	Keep in mind that ALL drivers of double seat scooters MUST be an EXPERIENCED Motorcycle / Scooter operator. By requesting Double Scooter(s) you are acknowledging that the driver who will operate the scooter is an experienced operator, capable of carrying a passenger.
Pick Up Date
Approximate Pick Up Time
Return Date
Approximate Return Time
Hotel name or address where you will be staying
Comments/Details