R1, 2024-08-09

NOTE: Susie's Mopeds does not accept paper waivers, please submit electronically.

Half Helmet Waiver

This is to attest:

I elect to wear the half DOT approved helmet instead of the recommend full faced helmet provided and inspected by Island Wheels LLC dba Susie's Mopeds Rentals.

Please enter your legal name as it appears on your ID.


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Signature

By checking here, you acknowledge you have read and understand the above terms, and are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.