Liberty Transportation

P.O. Box 2371

Sioux City, Iowa 51101
Ph. (712) 899-5669

Reservation Form

First Name:____________________ Last Name:____________________ Phone: (____)______-_______

Address: _____________________ City:_______________ State:_________ Zip:_________
E-Mail:__________________________________

Bus Selection:

□ Small Black Bus □ Pink Bus □ Limo Bus

Pick Up Time:______________ Pick Up Location:________________________

Drop Off Time:_____________ Drop Off Location: _______________________

Additional Details: ____________________________________________________________

____________________________________________________________
____________________________________________________________
Method of Payment:
□ Cash □Check □Money Order □Credit/Debit Card
Card Holder Name: _______________ Card Number: __________________________
Expiration(MM/YYYY):______/___________ Security Code:__________
Address: _________________ City:_______________ State:___________ Zip:__________
Printed Name: ______________________ Signature:_______________________________

§ Checks Returned For Any Reason, Including But Not Limited To Insufficient Funds, Closed Accounts, And Stop Payments Are Subject To A $35.00 Returned Check Fee.
 Liberty Transportation
P.O. Box 2371
Sioux City, Iowa 51101
Ph. (712) 899-5669

Reservation Agreement
All state and federal drug, alcohol, and weapons laws need to be followed while being
transported in any of our vehicles. There is No Smoking in the vehicles.
Payment & Gratuity
Remaining balance is due on arrival.
Deposits are non-refundable. In the event of a cancelation due to mechanical failure, inclement
weather, or any other uncontrollable circumstance, a full refund will be issued.
Parties Canceled within 48 hours are billed for full price.
With prompt and courteous service, a standard gratuity is 15 to 20 percent appreciated and accepted.
A $50.00 - $100.00 tip is appropriate.
Damages
Additional charges may accrue due to damaged property, and/or excessive messes left behind.
Charges for damages will be billed at the cost of materials, plus labor, and a $100.00 charge is
reserved for the clean up of any bodily fluids per incident, and/or debris left behind that require
extensive cleaning up.
Not responsible for any lost, damaged, and/or stolen personal property.
Safety
We reserve the right to remove individuals at any time. Subjects who become disorderly, extremely
intoxicated, and/or pose a safety risk to themselves and/or others will be removed, which may result
in the party being terminated. No refunds will be given if party is terminated.
Stand at your own risk. We may be caused to make abrupt stops in traffic and recommend staying
seated while bus is in motion. Please using hand rails when entering and exiting the bus. Not
responsible for injuries.
By signing this document, you agree to assume full responsibility for individuals during
transportation and agree to the terms and conditions listed above.
Printed Name: _____________________ Date: ________________
Signature: _____________________