Brabel Rental Services Reservation Form Name and Surname Address Country Drivers licence Passport number Date of birth Telephone, fax E-mail* Select type of vehicle A Fiat Panda A Fiat Seicento B Opel Corsa B Renault Clio C Smart C Opel Corsa automatic D Opel Astra automatic E Mazda 3 Sedan automatic F Peugeot 207 CC - Cabrio G Opel Zafira (7 seater) H Citroen C Crosser (7 seater) S Scooter 50 cc S1 Scooter 100 cc - Piaggio Fly S2 Scooter 200 cc - Piaggio Liberty S2 Scooter 250 cc - Piaggio X7 S3 Piaggio MP3 M Honda CBF600S - Sport touring M Kawasaki Versys 650 Pick-up Starting date Place Time Dropp off Ending date Dropp off place Dropp off time Payment Payment Cash MasterCard Visa Maestro Credit card number Valid till (month/year) Remarks Additional Info submit Please turn on javascript to submit your data. Thank you! Powered by BreezingForms
