WAIVER AND ASSUMPTION OF RISK

I client voluntarily sign this Waiver and Assumption of Risk in favor of Walker Medical & Mobility, inconsideration for the opportunity to use the Owner's electric scooters and wheelchairs.

I understand that there are certain risks and dangers associated with the activity and use of the electric scooters and wheelchairs. I fully understand the risks.

I fully assume the risks and I agree to use my best judgement in undertaking these activities and follow all safety instructions.

I waive and release the Owner from any claim for personal injury, property damage, or death that may arise from my use of the electric scooters and wheelchairs.


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Thank you for ordering on Walker Mobility Secure Order Page.
The page you are on assures that your information will remain private and your credit card information is secure and encrypted by the lock ("lock picture") located at the bottom of your browsers page. Please provide us the information needed so we can assist you with your reservation. This page will reserve your rental equipment for your stay in Central Florida.
You will receive an e-mail Order Confirmation/Number within the next 24 hours. Orders for delivery in the next 24 hours, or a single day rental, need to be phoned to our office.

Please complete the form below. Mandatory fields marked*

Step 1: Your Details
Step 2: Hotel Information
Step 3: Please Choose Equipment Needed
Equipment Rider Size Price Quantity Needed
(0-100)
Scooters
Standard Scooter Up to 300lbs.  $30.00/day
Standard Scooter w/Canopy Up to 300lbs. $30.00/day
+ one-time $20 charge per rental
Heavy Duty Scooter Up to 425lbs. $39.00/day
Heavy Duty Scooter w/Canopy Up to 425lbs. $39.00/day
+ one-time $20 charge per rental
Extended Range Heavy Duty Scooter Up to 500lbs. $46.00/day
Double Seat Stroller Up to 125lbs. $20.00/day, $10.00/each Add. Day
Single Seat Stroller Up to 75lbs. $20.00/day, $10.00/each Add. Day
Extended Range Heavy Duty Scooter w/Canopy Up to 500lbs. $46.00/day
+ one-time $20 charge per rental
       
Wheel Chairs
16 inch Children's Chair Up to 150 lbs. $30.00 1st day, $6.00/each Add. day
18 inch Up to 240lbs. $30.00 1st day $6.00/each Add. day
20 inch Up to 280lbs. $35.00 1st day $6.00/each Add. day
22 inch Up to 340lbs. $40.00 1st day $7.00/each Add. day
24 inch Up to 400lbs. $42.00 1st day $7.00/each Add. day
       
Companion Wheelchair Up to 250lbs. $30.00 1st day $6.00/each Add. day
       
Electric Wheelchair   $39.00 a day
Charging Harness   $20.00 one-time fee
WHEELCHAIR DAMAGE INSURANCE $10.00 one-time charge, per rental
SCOOTER DAMAGE INSURANCE $20.00 one-time charge, per rental
STROLLER DAMAGE INSURANCE $20.00 one-time charge, per rental

Step 4: Rider & Delivery Information

  4. Time:

  5. Time:
Step 5: Are You A Travel Agent?*
Travel Agent Details
Step 6: Payment Information
  1. Credit Card Type*



  5. Security Code Security Code
Step 7: Final Approval

Click here to review the Rental Agreement & Waiver of Liability
  Check box to Agree to Rental Agreement & Waiver of Liability


if (you have any questions, call us at 1-888-SCOOTER Monday thru Sunday 7:30am-8pm est.
Please Enter the words and/or Numerics shown below into the text field to ensure this is a live order and not spam. After enetring the code presented, Please then click on the Click Here link in Step 7 to transmir your order to us.