Name: Street Address: City: State: Zip Code: E-Mail   Phone Number: Local Phone Number: Card Type: Visa MasterCard American Express Discover Card Card Number: Expires: (mm/yy) *Date of Pick-up: 1 o'clock 2 o'clock 3 o'clock 4 o'clock 5 o'clock 6 o'clock 7 o'clock 8 o'clock 9 o'clock 10 o'clock 11 o'clock 12 o'clock : AM PM on: Sunday Monday Tuesday Wednesday Thursday Friday Saturday , January February March April May June July August September October November December , *Date of Return: 1 o'clock 2 o'clock 3 o'clock 4 o'clock 5 o'clock 6 o'clock 7 o'clock 8 o'clock 9 o'clock 10 o'clock 11 o'clock 12 o'clock : AMPM on: Sunday Monday Tuesday Wednesday Thursday Friday Saturday , January February March April May June July August September October November December , Renter Information Name Wt. Height Ability 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 Shoe Size Indicate Package Sport Deluxe Performance Beginner Snowboard Advanced Snowboard Demo Snowboard Helmet Sport Deluxe Performance Beginner Snowboard Advanced Snowboard Demo Snowboard Helmet Sport Deluxe Performance Beginner Snowboard Advanced Snowboard Demo Snowboard Helmet Sport Deluxe Performance Beginner Snowboard Advanced Snowboard Demo Snowboard Helmet Sport Deluxe Performance Beginner Snowboard Advanced Snowboard Demo Snowboard Helmet Sport Deluxe Performance Beginner Snowboard Advanced Snowboard Demo Snowboard Helmet Damage insurance is included with all ski and snowboard rentals.   RELEASE AGREEMENT PLEASE READ CAREFULLY BEFORE SKIING 1. I accept for use as is the equipment listed on this form and accept responsibility for the care of the equipement while its in my possession. 2. I will be responsible for the replacement at full retail value of any equipment rented under this agreement form, but not returned to Breckenridge Ski Shop. 3. I agree to reimburse and hold harmless the ski shop for any loss or damage of any kind, other than reasonable wear and tear, which results from the use of this equipment. 4. I agree to return all rental equipment by the agreed date in clean condition to avoid any additional charges. 5. I understand that there are inherent and other risks involved in the sport for which this equipment is to be used, snow skiing, that injuries are a common and ordinary occurrence of the sport, and I freely assume those risks. 6. I understand that the ski-boot-binding system will not release at all times or under all circumstances, nor is it possible to predict every situation in which it will release, and is therefore no guarantee for my safety. 7. I hereby release the ski shop and its owners, agents and employees from any and all liability for damage and injury to myself or to any person or property resulting from negligence, the selection, adjustment and use of this equipment, accepting myself the full responsibility for any all such damage or injury which may result. 8. I have made no misrepresentations to the ski shop in regard to my weight, height, age or skiier type. 9. I verify that the visual indicators on my bindings correspond to the settings as shown on this rental form. 10. All instructions on the use of my rental equipment have been made clear to me, and I understand the function of my equipment. Home | Reservations | Ski/Board Packages | E-Mail Breckenridge Ski Shop P.O.Box/211 N. Main St. Breckenridge, CO 80424 970/453-7039 Please visit BreckNet the most informative website for Breckenridge Colorado. Copyright © 2000 by InterNetWorks. All rights reserved. Webmaster@vail.net