Book transportation in Stark County, Greater Canton

Contact Information

Rider first name *

Rider last name *

Your email *

This is where we'll send your ride confirmation.

Your phone number *

This is the number we'll use to get in touch about the ride details (mobile preferred).

Ride Information

What date will we be picking up? *

What time for pick-up? *

Who will be riding with us? *

Rider's first name *

Rider's last name *

Your business or group name *

How many people are you expecting with your group? *

Is this a round-trip?

Will this ride also include a return trip?

Where can we pick you up? *

Where will we drop you off? *

1	Drop-Off Location * Please include stops and the time Pickup Time
1	Drop-Off Location * Please include stops and the time Pickup Time

Add a Stop

Will you require any of the following?

Wheelchair Lift/Access
Oxygen Tank
Child Booster Seat

Any other notes? *

Do you have any specific notes you would like us to know about the rider, the pick-up or drop-off location, parking, your pet, or anything else we can assist with?

Payment information

How do you prefer to pay for your ride? *

*Please note: Your ride with Koala Kruizers is not reserved until payment is made (or has been arranged ahead through Passport or Medicaid).

Is the billing address the same as the pick-up address you listed? *

Billing Address *

Apartment, Box Number, etc.

City *

State *

ZIP *

Contact Information

Rider first name *

Rider last name *

Your email *

This is where we'll send your ride confirmation.

Your phone number *

This is the number we'll use to get in touch about the ride details (mobile preferred).

Ride Information

What date will we be picking up? *

What time for pick-up? *

Who will be riding with us? *

Rider's first name *

Rider's last name *

Your business or group name *

How many people are you expecting with your group? *

Is this a round-trip?

Will this ride also include a return trip?

Where can we pick you up? *

Where will we drop you off? *

1	Drop-Off Location * Please include stops and the time Pickup Time
1	Drop-Off Location * Please include stops and the time Pickup Time

Add a Stop

Will you require any of the following?

Wheelchair Lift/Access
Oxygen Tank
Child Booster Seat

Any other notes? *

Do you have any specific notes you would like us to know about the rider, the pick-up or drop-off location, parking, your pet, or anything else we can assist with?

Payment information

How do you prefer to pay for your ride? *

*Please note: Your ride with Koala Kruizers is not reserved until payment is made (or has been arranged ahead through Passport or Medicaid).

Is the billing address the same as the pick-up address you listed? *

Billing Address *

Apartment, Box Number, etc.

City *

State *

ZIP *

Contact Information

First Name

Last Name

Your Email

Your Phone

Ride Information

Ride Date

Pickup Time

Who will be riding with us?

Rider's First Name

Rider's Last Name

Please provide your business, group, or organization name

How many people do you anticipate in your group?

Is this a round trip?

Where can we pick you up?

- Remove this stop

Where will we drop you off?

Pickup time from this stop

+ Add a stop

Book your ride with Koala Kruizers

Contact Information

Ride Information

Ready to book? Give us a call!

Contact us