Car Rental Insurance Waiver Form




Insurance Coverage Options

Please carefully read and indicate your choice by initialing one option below:


Option 1
___ (Renter’s Initials) I elect to purchase the optional insurance coverage offered by [Dash Drive Rentals LLC], which may include but is not limited to collision damage waiver (CDW), liability coverage, and/or personal accident insurance. I understand that coverage is subject to the terms and conditions of the rental agreement and the applicable insurance policy.
Option 2
___ (Renter’s Initials) I decline the optional insurance coverage offered by [Dash Drive Rentals LLC]. I understand that I am personally responsible for any and all loss, theft, or damage to the rental vehicle, and for any liability claims made against me during the rental period. I acknowledge that I have been advised to consult my own automobile insurance provider to determine if my personal policy provides coverage for rental vehicles. I assume full financial responsibility.

Acknowledgment and Release

By signing this waiver, I acknowledge that I have been provided the opportunity to purchase insurance coverage and have made an informed decision regarding such coverage. I release [Dash Drive Rentals LLC], its officers, employees, and agents from any claims related to loss, damage, or liability arising from my decision to accept or decline insurance coverage.

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