Only Fill Out This Form If Instructed To

This form is for private use only and will not confirm a reservation unless it was sent to you directly.

If you have questions or prefer to reserve over the phone,

please call or text during business hours.

10:30a-7pm Daily

541-857-8828

Private Reservation Form

Has Casey Instructed you to fill this form out? If no, STOP AND CALL*

Name*

Email*

Phone*

Pickup Address:*

Which sized Limo? (6,8,10 or 12 passenger. Yes small children count as a passenger for insurance purposes)*

Date and Start Time*

CC Number (No AMEX) Card is charged on day of service.*

Expiration*

CCV*

Billing ZIP Code for that card*

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