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.
You have been directed to a previous design of our 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 td>$20.00/day, $10.00/each Add. Day
Equipment Rider Size Quantity Needed
(0-100)

Scooters

Deluxe Scooter Up to 300lbs.
Deluxe Scooter w/Canopy Up to 300lbs.
Deluxe Heavy Duty Scooter Up to 425lbs.
Deluxe Heavy Duty Scooter w/Canopy Up to 425lbs.
Extended Range Heavy Duty Scooter Up to 500lbs.
Extended Range Heavy Duty Scooter w/Canopy Up to 500lbs.
Princess Scooter Deluxe Up to 300lbs.
Princess Scooter Deluxe w/Canopy Up to 300lbs.
Princess Scooter Deluxe Heavy Duty Up to 425lbs.
Princess Scooter Deluxe Heavy Duty w/Canopy Up to 425lbs.
Princess Scooter Extended Range Heavy Duty Up to 500lbs.
Princess Scooter Extended Range Heavy Duty w/Canopy Up to 500lbs.
Midnight Rider Scooter Deluxe Up to 300lbs.
Midnight Rider Scooter Deluxe w/Canopy Up to 300lbs.
Midnight Rider Scooter Deluxe Heavy Duty Up to 425lbs.
Midnight Rider Scooter Deluxe Heavy Duty w/Canopy Up to 425lbs.
Midnight Rider Scooter Extended Range Heavy Duty Up to 500lbs.
Midnight Rider Scooter Extended Range Heavy Duty w/Canopy Up to 500lbs.
Go-Go Elite Traveller Plus - 3 Wheel Up to 190lbs.
Double Seat Stroller Up to 125lbs.
Single Seat Stroller Up to 75lbs.
       

Wheelchairs

16 inch Children's Chair Up to 150 lbs.
18 inch Up to 240lbs.
20 inch Up to 280lbs.
22 inch Up to 340lbs.
24 inch Up to 400lbs.
       
Companion Wheelchair Up to 250lbs.
       
Electric Wheelchair  
Charging Harness  
WHEELCHAIR DAMAGE INSURANCE
SCOOTER DAMAGE INSURANCE
STROLLER DAMAGE INSURANCE

Step 4: Rider & Delivery Information

  1. Time:

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



  2. 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 through Sunday 7:30am-10pm EST.