Request a Reservation

So ya wanna rent a Harley®?

If you would like to request more information about renting a Harley, please fill out the following information.  You can pick your top 2 choices of motorcycles, and your top 2 choices for dates.  THIS IS NOT A RESERVATION but a reservation request.  Our Rental department will contact you as soon as possible to verify dates and models.

All information is confidential and will not be sold to any third party.

First Name:
Last Name:
Address:
City::			State
Zip:
Country of Origin:
Home Phone:
Cell Phone:
Work Phone:
I am:		Over 21    Over 25  Years of Age
Email:
Best Time to Call:		Early Morning, 9am to Noon Afternoon, Noon to 5pm Evening, 5pm to 8pm
1st Choice Model:		FLHTC Electra Glide Classic FLHR Road King FLSTN Softail Deluxe FXDF Dyna Fat Bob FLHX Street Glide XL1200N Sportster 1200 Nightster Buell 1125R
2nd Choice Model:		FLHTC Electra Glide Classic FLHR Road King FLSTN Softail Deluxe FXDF Dyna Fat Bob FLHX Street Glide XL1200N Sportster 1200 Nightster Buell 1125R
1st Choice Date:		Morning (9am-12pm) Afternoon (12pm-4pm) Evening (4pm-6pm)
2nd Choice Date:		Morning (9am-12pm) Afternoon (12pm-4pm) Evening (4pm-6pm)
Length of Rental:		1 2 3 4 5   Day(s) Week(s)
The following additional  items are also available:		Supplemental Liability Insurance	Accept	Waive
		Personal Accident and Property Insurance	Accept	Waive
		Loss Damage Waiver	Accept	Waive
		Tire Protection Plan	Accept	Waive
Have you rented a Harley before?		Yes No
Have you rented from Liberty before?		Yes No
Have you ridden a Harley before?		Yes No
Do you have a motorcycle endorsement on your Drivers License?		Yes No
How did you hear about Liberty Rentals?		Ad Body Shop Dealership Friend HOG Member Repeat Renter Signage H-D.com libertyharley.com
Why do you want to rent a Harley?  Please choose all that apply.
Thinking of buying		Visiting from out of town
Special Event		Enjoy riding, but not ready to buy
Other	Please specify:
	Request a Reservation