Order form
Your contact details
Number of wheelchairs: *
(max. 5)
Pick up time: *
(Date: dd.mm.yyyy) (Time: hh:mm)
Reservation will be expired one hour after the agreed pick up time.
Pick up location: *
please select
CCL
Entrance West/Eingang West (Glass hall/Glashalle)
Entrance East/Eingang Ost
Name: *
First name: *
Street/PO Box: *
Post code: *
Town: *
e-mail: *
Phone: *
* Required information!