Platinum Hertz_gold_no_ins by chenmeixiu


									                                                                                                                                                                                                                                                                                                                                                     Hertz #1 Club Gold® Enrolment Agreement
permission. Because of the nature of Hertz #1 Club Gold, You              LUXURY CARS. ALL CHARGES ARE SUBJECT TO CHANGE                   RESPONSIBILITY FOR DAMAGE TO THE VEHICLE. BEFORE                       DAMAGE OR THEFT IS CAUSED INTENTIONALLY OR BY THE
understand the urgency of this obligation.                                WITHOUT NOTICE. YOUR OWN INSURANCE (OR THAT OF AN                DECIDING WHETHER TO PURCHASE THE LOSS DAMAGE WAIVER,                   GROSS NEGLIGENCE OF YOU OR AN AUTHORISED DRIVER.
8. As of 1 January 2006, the Gold membership fee is US$50 for one         AUTHORISED OPERATOR) MAY COVER ALL OR PART OF YOUR               YOU MAY WISH TO DETERMINE WHETHER YOUR OWN                             Before deciding whether to purchase TP and/or CDW or SC, You
year, which fee may be waived by Hertz. At any time during the            FINANCIAL (OR THAT OF THE AUTHORISED OPERATOR) FOR               AUTOMOBILE INSURANCE AFFORDS YOU COVERAGE FOR                          should determine whether You have other insurance that affords
year You may notify the Enrolling Company in writing of Your              LOSS OR DAMAGE TO THE CAR.                                       DAMAGE TO THE RENTAL VEHICLE AND THE AMOUNT OF THE                     You coverage for loss of or damage to the Car and, if so, what the
desire to cancel Your Gold membership and obtain a refund of              10. NOTICE: THIS CONTRACT OFFERS, FOR AN ADDITIONAL              DEDUCTIBLE UNDER SUCH COVERAGE.                                        terms of such coverage are (including any limitations and
Your paid membership fee for the remaining months of the year.            CHARGE, A LOSS DAMAGE WAIVER TO COVER YOUR                       15. Under Minnesota law, a personal automobile insurance policy        excesses). Personal Insurance/Personal Accident Insurance (PI/PAI)
Hertz reserves the right to cancel or suspend Your membership for         RESPONSIBILITY FOR DAMAGE TO THE RENTAL VEHICLE. YOU             issued in Minnesota must cover the rental of the motor vehicle         is available at an additional daily charge and provides certain
any reason at any time, without notice. If Hertz cancels Your             ARE ADVISED TO CAREFULLY CONSIDER WHETHER TO SIGN THIS           against damage to the vehicle and against loss of use of the           benefits for You and Your passengers for accidental death.
membership, it will refund to You a pro rata portion of the               WAIVER IF YOU HAVE RENTAL VEHICLE COLLISION COVERAGE             vehicle. Therefore, purchase of any collision damage waiver or         Depending upon the country in which the rental commences,
membership fee You paid with respect to the period in which the           PROVIDED BY YOUR CREDIT CARD OR COLLISION INSURANCE              similar insurance affected in this Enrolment Agreement is not          PI/PAI may also provide benefits for permanent disability, certain
cancellation occurs, unless cancellation occurs following Your            ON YOUR OWN VEHICLE. BEFORE DECIDING WHETHER TO                  necessary if your policy was issued in Minnesota.                      injuries, medical and emergency expenses and/or damage to or
failure to pay any sums payable by You to Hertz or any of our             PURCHASE THE LOSS DAMAGE WAIVER, YOU MAY WISH TO                 16. FOR RENTALS COMMENCING IN TEXAS: YOU MAY NOT NEED                  theft of personal possessions (includes baggage) during the rental.
licensees, subsidiaries or other affiliates or Your violation of any of   DETERMINE WHETHER YOUR OWN VEHICLE INSURANCE                     THE                                                                    18. For rentals in Australia, Hertz will, subject to certain exceptions
the terms of this Agreement or any other obligation owed by You           AFFORDS YOU COVERAGE FOR DAMAGE TO THE RENTAL                    AUTOMOBILE INSURANCE OFFERED BY HERTZ. YOUR TEXAS                      under the Rental Agreement, associated with Prohibited Uses,
to any Hertz company. If You return Your Gold card within thirty          VEHICLE AND THE AMOUNT OF THE DEDUCTIBLE UNDER YOUR              AUTOMOBILE POLICY PROVIDES COVERAGE FOR YOUR LIABILITY                 Prohibited People and Full Responsibility Uses, be responsible for
(30) days of receipt, and before renting a car using Gold, then You       OWN INSURANCE COVERAGE. YOU ARE ALSO ADVISED TO                  WHILE OPERATING A RENTAL VEHICLE. AUTOMOBILE POLICIES                  any loss of or damage to the rental car, except for the first
will receive a full refund of Your membership fee. Your                   DETERMINE WHETHER SUCH COVERAGE IS PROVIDED UNDER                ISSUED IN OTHER STATES OR COUNTRIES MAY ALSO DUPLICATE                 AUS$2,750.00 (including GST), Accident Damages Excess (ADE) or
membership will expire on the expiration date specified on Your           THE AGREEMENT REGARDING THE CREDIT CARD WHICH IS USED            THIS COVERAGE. THE PURCHASE OF AUTOMOBILE RENTAL                       such other amount specified on the Rental Agreement. An
Gold Card, or in the absence of such expiration date after 12             TO PAY FOR THE RENTAL OR FROM ANY OTHER SOURCE AND IF            LIABILITY INSURANCE IS NOT REQUIRED AS A CONDITION OF                  additional Accident Damage Excess of AUS$2,200 (including GST)
months from submission to You of such card, unless, in either case,       SO, THE TERMS AND SCOPE OF SUCH COVERAGE. THE PURCHASE           RENTING AN AUTOMOBILE. THIS INSURANCE DOES NOT APPLY                   applies to each instance of a Single Vehicle Accident or Water
Your membership is renewed or extended for an additional period           OF THIS LOSS DAMAGE WAIVER PRODUCT IS NOT MANDATORY              TO ANY BODILY INJURY OR PROPERTY DAMAGE ARISING OUT                    Damage other than by total or partial immersion. Optional
of 12 months upon payment by You of any membership renewal                AND MAY BE DECLINED.                                             OF THE USE OR PERMITTING THE USE OF A RENTAL VEHICLE BY                Accident Excess Reduction is offered for AUS$22.00 (including
fee notified to You by Hertz. Hertz reserves the right not to renew       11. THE INSURANCE COVERAGES OFFERED BY HERTZ MAY                 ANY DRIVER WHILE UNDER THE INFLUENCE OF DRUGS OR                       GST) per full or partial rental day to reduce the standard ADE to
Your membership and will not be obliged to provide any                    PROVIDE A                                                        ALCOHOL IN VIOLATION OF THE LAW.                                       AUS$375.00 or such other amount specified on the Rental
explanation for not doing so.                                             DUPLICATION OF COVERAGE ALREADY PROVIDED BY A RENTER’S           17. For rentals in Europe, Middle East and Africa (EMEA), Hertz        Agreement (including GST). Optional Accident Excess Reduction
9. THE FOLLOWING INFORMATION IS PROVIDED REGARDING                        PERSONAL AUTOMOBILE INSURANCE POLICY OR BY ANOTHER               offers a                                                               Plus (AER PLUS) is offered for AUS$28 (including GST) per full or
YOUR                                                                      SOURCE OF COVERAGE. THE PURCHASE OF THESE KINDS OF               number of optional services each for an additional daily charge. If    partial rental day; AER PLUS provides the same benefits as AER and
RESPONSIBILITY FOR LOSS OF OR DAMAGE TO ANY CAR WHICH                     COVERAGE IS NOT REQUIRED IN ORDER TO RENT A VEHICLE.             taken, Theft Protection (TP) will limit Your responsibility for loss   also eliminates liability for tyre and/or windscreen damage. The
YOU RENT IN THE UNITED STATES OR CANADA USING GOLD.                       12.FOR RENTALS COMMENCING IN THE DISTRICT OF COLUMBIA.           of or damage to the Car, its parts or accessories, which is caused     additional Single Vehicle Accident and Water Damages Excesses
MORE DETAILED INFORMATION APPEARS IN PARAGRAPH 4 OF                       WARNING:FAILURE TO RETURN THE CAR IN ACCORDANCE WITH             by theft, attempted theft or vandalism to the non-waivable excess      cannot be reduced through the purchase of AER or AER PLUS.
THE NORTH AMERICAN TERMS. EXCEPT AS STATED IN                             THE TERMS OF THE RENTAL AGREEMENT MAY RESULT IN A                stated on the Rental Record. If taken, Collision Damage Waiver         Other Renter Protection Options are available at participating
PARAGRAPH 4 OF THE NORTH AMERICAN TERMS, YOU ARE                          CRIMINAL PENALTY OF UP TO 3 YEARS IN JAIL.                       (CDW) will limit Your responsibility for loss of or damage to the      locations. For rentals in New Zealand, You are liable for the first
RESPONSIBLE FOR ANY AND ALL LOSS OF OR DAMAGE TO THE                      13.Unless waived, a renter in Miami-Dade County must be          Car, its parts or accessories, other than caused by theft, attempted   NZ$2,200.00 (NZ$2,500.00 for vehicle groups H, J, K, L & M) or any
CAR REGARDLESS OF FAULT. FOR RENTALS IN THE UNITED                        furnished a                                                      theft or vandalism, for each such incidence of loss or damage          other amount as shown on the Rental Agreement (plus GST) of
STATES AND CANADA, HERTZ OFFERS, FOR AN ADDITIONAL                        county-approved visitor information map. These maps are          arising from a separate event, to the non-waivable excess stated on    any loss or damage to the rental vehicle referred to in the
CHARGE, A LOSS DAMAGE WAIVER (LDW). IF YOU ACCEPT LDW,                    available                                                        the Rental Record. If You take CDW and TP, You may also take           insurance cover specified in clause 10 of the Terms & Conditions
WHICH IS NOT INSURANCE, HERTZ WILL NOT HOLD YOU                           at all Hertz locations in Dade County. Each renter must either   Super Cover (SC), in which case You will receive the benefit of        applicable to Gold rentals in New Zealand. This does not apply to
RESPONSIBLE FOR LOSS OF OR DAMAGE TO THE CAR, SUBJECT                     acknowledge receipt of such a map or waive his or her right to   CDW and TP and Your liability for the excesses in relation to both     damage or loss resulting from fire or theft or conversion or
TO CERTAIN RESTRICTIONS AND EXCLUSIONS WHICH ARE                          receive such a map. By signing the Enrolment Form, You hereby    CDW and TP will be eliminated. SC is not available in some             attempted theft or conversion of the vehicle. This liability may be
DISCUSSED IN PARAGRAPH 4(d), 4(e) AND 5 OF THE NORTH                      waive Your right to receive such a map.                          countries or for rentals attached to certain CDP numbers. If you       reduced to NZ$0 by payment of the optional Accident Excess
AMERICAN TERMS. IN THOSE STATES WHERE THE SALE OF LDW                     14. NOTICE: IF YOU HAVE COLLISION COVERAGE UNDER YOUR            choose SC and it is not available for Your rental, You will receive    Reduction of NZ$22.00 per day (NZ$25.00 per day for vehicle
IS REGULATED OR PROHIBITED, THAT LAW WILL GOVERN YOUR                     OWN                                                              Super Collision Damage Waiver (SCDW), where available, and TP. If      groups H, J, K, L & M), plus GST. All rates, excess, and reduction
RESPONSIBILITY FOR LOSS OR DAMAGE TO THE CAR. LDW                         AUTOMOBILE INSURANCE POLICY WRITTEN IN LOUISIANA,                SCDW is also not available, You will receive CDW and TP. If You are    amounts are stated as of 1 January 2006, are subject to change
ENTAILS AN ADDITIONAL CHARGE. AS OF 1 JANUARY 2006, THE                   YOUR COLLISION COVERAGE AUTOMATICALLY EXTENDS TO                 given SCDW, You will receive the benefit of CDW and Your liability     without notice and may vary with rate and vehicle options.
CHARGE FOR LDW AT MOST GOLD LOCATIONS IN THE UNITED                       RENTAL MOTOR VEHICLES PURSUANT TO R.S. 22:1406(F). EVEN IF       for the excess in relation to CDW will be eliminated (although You
STATES OR CANADA IS US$26.99 OR CAN$30.95, RESPECTIVELY,                  YOU ARE NOT A LOUISIANAINSURED DRIVER, THE PURCHASE OF           will remain liable for the excess in relation to TP). THE BENEFITS
                                                                                                                                                                                                                                                                                                                     The Platinum Card.
                                                                                                                                                                                                                                                                                            CAM4782 10/06   Department 68, Brighton, BN88 1AH, UK.
  HERTZ #1 CLUB GOLD® ENROLMENT AGREEMENT                                                                                                You may limit the use or disclosure of personally identifiable data about you by ticking one of the boxes within each of A and B            RENTALS IN EUROPE, MIDDLE EAST, AFRICA, AUSTRALIA AND NEW ZEALAND                                                            ENROLMENT TERMS
  TO ENROL, PLEASE COMPLETE ALL SECTIONS, SIGN AND RETURN THIS AGREEMENT IN THE ENCLOSED ENVELOPE. DO NOT DETACH                         below.A. I give Hertz permission to send me marketing offers or materials in the course of Hertz’ rental businesses and to disclose         PLEASE SELECT THE CLASS OF CAR YOU WISH TO RENT WHEN USING HERTZ #1 CLUB GOLD.                                               DO NOT DETACH, THE ENROLMENT TERMS MUST BE RETURNED WITH THE ENROLMENT FORM.
  THE ENROLMENT TERMS.                                                                                                                   personally identifiable data about me collected in the course of Hertz’ rental businesses to Hertz’ affiliates or licensees for
                                                                                                                                                                                                                                                                                                                                                                                                                  By signing the Enrolment Form, You acknowledge and agree              3. When You rent a private passenger motor vehicle (excluding
                                                                                                                                         marketing purposes.
  PERSONAL INFORMATION FOR ALL RENTALS                                                                                                                                                                                                                                               THE CAR CLASS YOU WISH TO DRIVE: (tick one)                                                                                  that:                                                                 trucks and vans), including all such vehicle’s parts (a “Car”), using
                                                                                                                                                                                                                                                                                                                                                                                                                  1. You have received, read, understand and agree to the terms,        Gold, the Hertz company or licensee providing the Car is called
                                                                                                                                         1.        Postal Mail Only 2. E-Mail Only 3. Both Postal and E-Mail                                                                                                                                                                                                      conditions, disclosures and notices on this Hertz #1 Club Gold        the “Renting Company”. Your Enrolment, together with the terms
  HERTZ #1 CLUB NUMBER                                                    HERTZ CDP NUMBER                                                                                                                                                                                                Manual            Automatic            Economy               Compact               Intermediate         Standard
  (IF APPLICABLE)                                                         (IF APPLICABLE)                                                4.        I direct Hertz not to send me any marketing offers or materials in the course of Hertz’ rental businesses and not to disclose                                                                                                                                  Enrolment Agreement. This Enrolment Agreement pertains to             and conditions in the aforementioned booklet(s) which are
                                                                                                                                                   personally identifiable data about me collected in the course of Hertz’ rental businesses to Hertz’ affiliates or licensees for        Full-Size         Premium                                                                                               Hertz #1 Club Gold (“Gold”) rentals wherever Gold service is          applicable to rentals in the country in which the rental
  ACCOUNT NAME OF CDP NUMBER                                                                                                                       marketing purposes.                                                                                                                                                                                                                                            available; as of 1 January 2006, Gold service is available in the     commences (as modified by Hertz from time to time in the
  (IF APPLICABLE)                                                                                                                                                                                                                                                                    In EMEA, automatic cars are subject to availability.
                                                                                                                                                                                                                                                                                                                                                                                                                  United States, Canada, much of Europe, Israel, South Africa,          manner prescribed therein), the Rental Record or Rental
  NAME, ADDRESS & TELEPHONE INFORMATION                                                                                                  If you do not tick any of the boxes above, you will be deemed to have selected item 4. If you select item 4, you may not                                                                                                                                                 Australia and New Zealand. One or more booklets setting forth         Agreement which You receive at the commencement of the rental
                                                                                                                                         receive offers and services that may be of interest to you. These include discount and free rental day vouchers that Hertz would            HERTZ NEVERLOST® NAVIGATIONAL SYSTEM:                                                                                        the terms and conditions applicable to Gold rentals in all            (excluding, in the case of a rental agreement, the preprinted
  Title:            Mr.       Mrs.          Miss.         Ms.            Dr.      Other                                                  otherwise provide to you under the Hertz #1 Club Gold Five Star¨ and Hertz #1 Club Gold President’s Circle¨ programmes, plus                                                                                                                                             countries in which Gold service is available, and for which You       general terms and conditions section thereof, if any), and any
                                                                                                                                         other similar loyalty programmes.                                                                                                               Tick here if you prefer a vehicle equipped with a Hertz NeverLost Navigation System (where                               enrol to rent withGold, will be sent to You following acceptance      other documents which You are required to sign at the
  Surname:                                          First Name:                                                 Middle Initial:                                                                                                                                                      applicable). An additional charge will apply. Hertz NeverLost is only available in certain ENEA                              by us of this Enrolment Agreement; however, if we have already        commencement of the rental, will constitute the agreement
                                                                                                                                         B. 1.       I give Hertz permission to disclose personally identifiable data about me collected in the course of Hertz’ rental              countries/locations.                                                                                                         sent You a current booklet covering rentals in certain countries,     between You and the Renting Company governing the rental. The
  HOME INFORMATION                                                                                                                                   businesses to companies that are not Hertz’ affiliates or licensees for marketing purposes.                                                                                                                                                                  we may not send You a second copy of that booklet. You promise        identity of the Renting Company for each rental will appear on
                                                                                                                                              2.     I direct Hertz not to disclose personally identifiable data about me collected in the course of Hertz’ rental businesses to     AUSTRALIA/NEW ZEALAND                                                                                                        to read the booklet(s) carefully. Your making a rental using Gold     the Rental Record/Agreement for that rental. The Enrolling
  Home Address:                                                                                                                                                                                                                                                                                                                                                                                                   will constitute Your acceptance of all terms and conditions           Company and the Renting Company are referred to collectively as
                                                                                                                                                     companies that are not Hertz ’affiliates or licensees for marketing purposes.
                                                                                                                                                                                                                                                                                     THE CAR CLASS YOU WISH TO DRIVE: (tick one)                                                                                  specified in the booklet(s), including the General Provisions         “Hertz”, “we” or “us”.
  Town/City:                                                                                  Postcode:                                                                                                                                                                                                                                                                                                           Applicable To All Hertz #1 Club Gold Rentals (the “General            4. The availability of Gold service at specific locations may change.
                                                                                                                                         CARD INFORMATION                                                                                                                                                                                                                                                         Provisions”), the Terms And Conditions Applicable To Rentals In       Reservations made not less than two (2) hours in advance of
                                                                                                                                                                                                                                                                                          Economy             Compact             Intermediate               Full-Size            Luxury (Australia only)
  Country:                                                                      Telephone:                                               Please provide your Platinum Card details below. The billing address for your card must be one of the adresses you list                                                                                                                                                  The United States And Canada (the “North American Terms”), the        proposed rental commencement are required for Gold rentals.

                                                                                                                                         above.                                                                                                                                      4
                                                                                                                                                                                                                                                                                     See paragraph #18 of the Enrolment Terms.                                                                                    Terms And Conditions Applicable To Rentals In Europe, Middle          5. You represent that the information which You have provided on
  COMPANY INFORMATION                                                                                                                                                                                                                                                                                                                                                                                             East and Africa (the “EMEA Terms”), the Terms And Conditions          this Enrolment Agreement is true, correct and complete. Your
                                                                                                                                         Card Number: 3 7                                                                     Expiry Date: d d         m m       y y y y

                                                                                                                                                                                                                                                                                     In Australia, most cars are automatic. In New Zealand, Intermediate and Full-Size are automatic.
                                                                                                                                                                                                                                                                                                                                                                                                                  Applicable To Rentals In Australia, the Terms And Conditions          selections in the Enrolment of Optional Services (where available)
  Company Name:                                                                                                                                                                                                                                                                                                                                                                                                   Applicable To Rentals In New Zealand and the Company/Travel           and car class (subject to vehicle availability at the time You make
                                                                                                                                         HERTZ #1 CLUB GOLD® RENTALS IN THE U.S. AND CANADA                                                                                          SIGNATURE: MUST SIGN TO ENROL                                                                                                Agent Accounts Supplementary Terms and Conditions. If, after          the reservation) will apply to all rentals which You make using

  Company Address:                                                                                                                                                                                                                                                                   BE CERTAIN TO COMPLETELY FILL OUT EACH SECTION BEFORE MAILING. I ACKNOWLEDGE THAT I HAVE
                                                                                                                                                                                                                                                                                                                                                                                                                  reading the booklet(s), You wish to change any of the selections      Gold; provided, that for a specific rental You may change Your

                                                                                                                                         PLEASE SELECT THE CLASS OF CAR YOU WISH TO RENT WHEN USING HERTZ #1 CLUB GOLD.                                                                                                                                                                                           on this Enrolment Form, You may do so in the manner described in      selections of Optional Services and You may select a different car
                                                                                                                                                                                                                                                                                     RECEIVED, READ AND UNDERSTAND THE TERMS, DISCLOSURES AND NOTICES ON THE ENROLMENT TERMS,
  Town/City:                                                                                  Postcode:                                  THE CAR CLASS YOU WISH TO DRIVE: (tick one)
                                                                                                                                                                                                                                                                                                                                                                                                                  section 2, below.                                                     class in the manner provided in the Terms and Conditions

                                                                                                                                                                                                                                                                                     INCLUDING BUT NOT LIMITED TO THE NOTICES IN SECTIONS 9 THROUGH 18 THEREOF.                                                   2. The submission of this Enrolment Agreement represents an offer     applicable to the country in which the rental commences.
  Country:                                                                      Telephone:                                                                                                                                                                                           I understand that Hertz #1 Club Gold rentals (including optional services which I select) will be governed by the            by You. The Hertz company the name of which appears on the            Notice: For rentals at some locations, certain optional services
                                                                                                                                                   Compact, 4-Door              Mid-Size           Sporty, 2-Door            Full-Size, 4-Door           Premium            Luxury   Hertz #1 Club Gold Rental Terms and Conditions as well as the Enrolment Terms and agree that my first                        front of this Enrolment Form (the “Enrolling Company”) reserves       may not be available on the basis of an advance request in Your
  Fax:                                              Preferred E-Mail Address:                                                                                                                                                                                                        Hertz #1 Club Gold rental will constitute my acceptance of the Hertz #1 Club Gold Terms and Conditions.                      the right not to accept this Enrolment Agreement without being        Enrolment to obtain them. In such circumstances, the Rental
                                                                                                                                                   SUV, 4-Wheel Drive                                                                                                                                                                                                                                             required to provide any explanation. Acceptance of this Enrolment     Record/Agreement will indicate that You have declined to obtain
  DRIVING INFORMATION                                       Preferred Mailing Address: (Please tick one only)       Home      Company                                                                                                                                                                                                                                                                             Agreement by the Enrolling Company will be given by written           such optional services, even though Your Enrolment agreement
                                                                                                                                         HERTZ NEVERLOST® NAVIGATIONAL SYSTEM:                                                                                                                                                                                                                                    notice. You may from time to time update the information and          specifies that You wish to obtain them. You may be able to
  Date of Birth: (Must be at least 21 years) d d    m m    y y y y Country of Birth:
                                                                                                                                              If you have selected a Mid-Size or larger vehicle, you may tick here if you prefer a vehicle equipped with a                           SIGNATURE X                                                                                        DATE                      change the selections on this form by written notice to the           purchase such services at the commencement of the rental even
                                                                                                                                                                                                                                                                                     (Must sign to be eligible.)                                                                                                  Enrolling Company or through Hertz’s Internet website,                when they are not available
  Driver’s Licence Number:                                                                                                               Hertz NeverLost Navigational System. An additional daily charge applies. If you select NeverLost you will receive                                                                                                                                               This Enrolment Agreement, as             in advance.
                                                                                                                                                                                                                                                                                     Please read the following terms, conditions, disclosures and notices (the “Enrolment Terms”) before signing the agreement.   modified to reflect any changes which You may make to Your            6. You authorise Hertz to process all charges in any way incurred
                                                                                                                                         this service in the U.S. and Canada (where available).
  Issuing Authority (Country)                                                                                                                                                                                                                                                                                                                                                                                     elections on this form, is referred to as Your “Enrolment” for the    by You in connection with a Gold rental against the first credit
                                                                                                                                         SIRIUS SATELLITE RADIO:                                                                                                                                                                                                                                                  countries covered hereby. If accepted by Hertz, this Enrolment        card listed on the front of this Enrolment Agreement (as such list
 Driver’s Licence Issue Date:          d d         m m    y y y y                   Expiry Date: d d            m m        y y y y                                                                                                                                                                                                                                                                                Agreement will supersede any Enrolment Agreement submitted by         may be modified from time to time in the manner described in
                                                                                                                                                   Tick here if you prefer a vehicle equipped with SIRIUS (subject to availability). An additional change applies.                                                                                                                                                You which was accepted by Hertz prior to acceptance of this           section 2, opposite) which has available credit or funds, as the case
  CUSTOMER’S CHOICE TO LIMIT USE OF DATA                                                                                                                                                                                                                                                                                                                                                                          Enrolment Agreement, with respect to those countries. The supply      may be, and which is accepted to qualify for rental at the rental
                                                                                                                                                                                                                                                                                                                                                                                                                  of the information requested on this Enrolment Form is voluntary.     location.
  We are The Hertz Corporation and its subsidiaries (“Hertz”). To provide you with the opportunity to participate in offers and          NON-SMOKING/SMOKING OPTION FOR U.S. AND CANADA RENTALS: (tick one)                                                                                                                                                                                                       However, Hertz reserves the right to reject Your application for      7. You promise to notify the Enrolling Company at once if Your
  services which we believe would be of interest to you, where legally permitted and in accordance with our Privacy Policy, Hertz may
  send you mailings and disclose personally identifiable data about you to Hertz’ affiliated companies, Hertz’ independent licensees                                                                                                                                                                                                                                                                              membership if You do not supply all of the information requested      Gold Card, Hertz Charge Card, #1 Club number or any of the credit
                                                                                                                                                   Non-Smoking Car              Smoking Car             No Preference.                                                                                                                                                                                            or for any other reason. See the General Provisions for information   cards listed in Your Enrolment are lost, stolen or invalidated, or if
  and other companies for their marketing purposes. Please read Hertz’ Privacy Policy. To obtain a copy of our Privacy Policy for
  Rental Customers, please write to Director, Privacy Services, Hertz Europe Financial Centre, Swords, Co. Dublin, Republic of Ireland   In the U.S. and Canada most cars are automatic.                                                                                                                                                                                                                          regarding our use of personal data.                                   You suspect that any of them are being used without Your
  or go to                                                                                                                                                                                                                                                                                   Hertz Europe Ltd, Hertz, 11 Vine Street, Uxbridge, Middlesex, UB8 1QE, UK.

S61395PX01                                                                                                                        Z04                                                                                                                            PLTICC01                                                                                                                                                                                                                                                    2234/EZ/MK/OUT/EA 0306

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