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Rental Application

Stone Canyon Rentals

DBA of: Stone Canyon SD, LLC

(605) 440-0182

675 West Mt. Rushmore Rd, Custer, SD 57730                                    Fax (605) 673-3699 

Reservation Application

Name_________________________ Phone: (      )_____________Cell Phone #___________________

Address _______________________City ___________________ State __________ Zip ___________

Employer ______________________Phone (       )_____________Position ______________________

Address _______________________City ____________________State __________ Zip __________

Annual Household Income (    ) $30,000 - $55,000 (    ) $55,000 - $80,000 (    ) $80,000 or more 

Auto Make & Yr ________________License # ________________State________________________ 

Rental Information:                 

Start ___/____/_____  Time ________am/pm  End ____/____/____ Time ________am/pm

Unit _____________________________ # in Party: Adults_________Children__________

Ever Tow a Camper Trailer Before (   ) YES  (   ) NO

Pick-up unit in  ______Custer, SD__________ Drop-off unit in ____Custer, SD________

Destination of this Trip ______________________________________________________________
Referral By (  ) Internet (   )Ad (   ) Friend 

Units are Non-Smoking / No-Pet – If you are a smoker, you will have to do it outside of the unit. 

          (   ) Smoker    (   ) Non-Smoker                                                     Please initial here____________.

Cancellation Policy:    All cancellations must be in writings and are subject to a $100 processing fee.   Cancellations within 45 days prior to departure are subject to a $250 fee and all monies collected within 30 days prior to departure are non refundable.                                          Please initial here___________.  

Insurance required:  Most auto insurance companies extend coverage to towed vehicles.  Please verify coverage with your insurance company before renting a travel trailer or pop up unit.  Proof of insurance is required.  The renter is responsible for any damage, loss of use, or other loss.                                                                                                               Please initial here___________. 

Electric Brakes & Tow Vehicle Ratings:  Camper & Trailers weighing 3,000 lbs or more are required to use electric brakes.  It is the renter’s responsibility to have the proper brake controller unit installed on their tow vehicle prior to the units’ departure from our rental location.  The renter is also responsible to verify that the towing vehicle has the capacity to properly tow the  trailer.                Please initial here___________. 

Renter or Drivers of Tow Vehicle:

Full Name of Driver #1 __________________________ Age __________ Date of Birth____/___/____

Drivers License #  ______________________________ State __________Exp. Date ______/___/____

Full Name of Driver #2 __________________________ Age __________ Date of Birth  ___/___/____

Drivers License #  ______________________________ State __________Exp. Date ______/___/____

The above information is true & correct to the best of my knowledge.  I agree to pay credit card charges as noted below:

Applicant’s Signature ____________________________________  Date:________/______/_______

Deposit of $250.00   (      )        Total Rental Fee (45 days or less prior to rental)  Agreement:  (    )

(   )Visa        (  )Master Card        (   )Discover Card        (   )Check or Money Order 

Credit Card # _________________________________  Exp. Date ________/______/________