Courtesy Car Application Form

    First Name

    Last Name


    Mobile Phone Number

    Vehicle Rego being worked on

    I have a valid Full New Zealand Driver's License

    In order to confirm your courtesy car booking we first need to confirm your Drivers License details.

    Please either provide photos of BOTH SIDES of your Full Driver's License
    Email them to [email protected]

    Terms and Conditions

    • First 10km are free, then 50c/Km. This covers repairs, servicing, Rego’s, WOF’s, insurance and petrol.

    • Drivers must be over 21 and provide a FULL NZ driver’s licence. This will be photocopied.

    • Car is only to be used within the Hamilton city area, or within a 10 km radius from Grimmer Motors. (unless otherwise agreed and noted on this form).

    • No smoking, eating, drinking or pets are allowed in the car.

    • There is a cleaning fee of $50 if someone has smoked in the car, there is food, drink, pet remains or bad smells in the car, or if it is returned dirty.

    • The Customer agrees to return the car on the ‘date agreed for return’, or on the day of notification your car is ready for collection. If this car is not delivered back by the time agreed and there has been no agreement from Grimmer Motors to extend the time period, then Grimmer Motors has the option to charge an additional $50 per day until the Courtesy Car is returned.

    • The Customer agrees to exercise all reasonable care and diligence in the security and care of the car including using a steering lock when the car is parked (if a steering lock is provided). The Customer agrees to accept full responsibility for the full cost of repairing any damage and for any losses to this car or other people’s property arising from the customer driving this courtesy car.

    • In the event of damage or theft caused to the car or other parties property, the Customer agrees to accept full responsibility and will be liable for the lesser of Grimmer Motors insurance excess costs of $1500 if over 25, $2000 if 21 to 25 (cars loaned at our discretion), or the cost to repair or replace the car.

    • Any damage or mechanical problem must be reported to Grimmer Motors immediately.

    • The Customer will not park the car in a situation where it is more likely to get vandalized, broken into, or stolen, such as on the roadside overnight.

    • If the Customer gets a flat car battery due to leaving lights on, or any other electrical load on, then it is the Customers responsibility to pay for the battery charge, repair or call out fee.

    • If the Customer gets a speeding, parking ticket or any other form of fine while using this car, then the Customer agrees to immediately pay Grimmer Motors for the full amount of this speeding, parking ticket, or other fine on proof of ticket, fine, or payment demand from Grimmer Motors.

    • This agreement is only with the signed Customer. The Customer will not let anyone else drive this car. If the Customer does allow someone else to drive this car, then the Customer will still be liable under this agreement as if they were driving this car.

    • Magnetic courtesy car signs attached to the car must not be removed, or tampered with.

    • If any one or more of the Terms and Conditions above are found to be unenforceable, then the rest of the Terms and Conditions still apply.

    Your signature to confirm you agree to the terms and conditions listed above,
    as well as having filled out the form truthfully and to the best of your ability.
    By typing your full name into the box below, you agree that this is your Electronic Signature,
    the same as if you where handwriting your signature