Rental Car Driver Agreement

As an authorized driver for a rental vehicle paid for and coordinated by ESL, please complete the form below.

    *Your Full Legal Name (Driver)

    *Your Phone

    *Your Email

    *Your Home Address

    *Your driver's license State, Number and Expiration Date

    *The driver accepts responsibility for renting the vehicle as an authorized driver. (Yes / No)

    *The driver understands to accept the Damage Waiver only. (Yes / No)

    *The driver understands to NOT accept additional insurances or coverages from the rental agency. (Yes / No)

    *The driver understands to NOT accept the fuel option. The pre-paid fuel option is NOT authorized - fuel must be purchased by driver prior to returning the vehicle and reimbursed with the proper receipt showing time, date, gallons, price per gallon and total charge. (Yes / No)

    *The driver understands the term/length of the authorized rental days and authorized charges. Additional days, GPS charges, add-ons or upgrades are NOT reimbursable. Any driver induced fees, such as but not limited to parking tickets, toll violations, smoking in the vehicle fees and un-announced out-of-state travel fees are NOT reimbursable. (Yes / No)

    *The driver understands the Scope of Use of the vehicle is limited to work-related travel and necessary trips only, such as for traveling to or from work, for food, for work-related errands, etc. (Yes / No)

    *Please upload a photo of your Driver's License


    *Your Signature Please Sign legibly within the box below (use the clear button to refresh only this section)


    Click once to submit- wait for confirmation