BOOKING FORM – MD Limousine Service, Inc.

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Date and Time of service

Date*

Time*

Where should we pick you up?

Please fill an address or Airport details

City*

Address

Airport

Airline

Flight

Where are you going?

City*

Address

Airport

Airline

Flight

Trip type*

Vehicle type*

Passengers*

Luggages*

I have a pet riding with me

I need a booster

I need a car seat

I need an infant car seat

Passenger Information

First name*

Last name*

Email*

Phone Number*

Comments

Untitled

Credit card information

Card number*

Name on the card

Valid until (year):*

Valid until (month):*

CVC *

I, hereby authorize M.D. Limousine Inc. to charge the above listed credit card account the amount indicated on my contract, and that I will in good faith, make good on the contracted charges. I, the undersigned, do hereby personally guarantee payment of the full contracted amount in the event of non-payment without just cause by the above named company. A non-refundable 30% fee will be charged for contracts cancelled without sufficient notice.

Drivers have credit card machines in all limos. We also accept cash. When placing your reservation, please mention any quote you received from our representative either over the phone or via the internet form. We will call or e-mail you immediately to confirm receipt. Thank You!

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