Segway Tour Registration Form

*Price is $39.99 plus tax per person *must be 16 years of age or older *under 18 must be accompanied by an adult *all reservation requests will be confirmed by a Moving Forward Rentals representative *please have your credit card information available

Name
Email Address
Telephone Number
Date Requested
Touring Time	10 am12 pm2 pm4 pm
Number of People	12345678910
Special Comments