Name

Telephone

Email

Date of Event

Pick-up Location

Drop-off Location

Pick-up Time

Drop-Off Time

Type of Event

If other, please state

Type of Journey:

No. of Passengers

In accordance with the Data Protection Act 196 of 30/06/2003 the data will be utilised by Xtreme Limo electronically and automatically, for statistical means and to inform the data subject of eventual company changes. The Data will not be passed on to third parties for reasons other than legal or contractual. It is within the rights of the Data subject to check, update, cancel or oppose the use of the Data according to that foreseen by paragraph 7 of the above Act.