Westminster Party and Tent Rentals LTD.

I, WE_________________________________________________________

Driver's Licence #___________________________Issued date___________

Birth date________________

Street address_____________________ Mailing address________________

City_____________________ Prov._____________ Postal code__________

Authorize Westminster Party and Tent Rentals LTD.
102 - 1875 Government Street
Penticton, B.C. V2A 8N9

To use my card #_____________________________ exp________________

Name on the card________________________________________________

For any outstanding balances, late charges or damages to rental equipment
occurring while in MY, OUR POSSESSION.

I, WE the undersigned, declare all the above information provided is true.

_________________________________ Date_____________________

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________________________________ Date______________________

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