ONLINE RESERVATION FORM
YOUR RESERVATION WILL NOT BE AUTOMATICALLY CONFIRMED!
WE WILL CALL YOU BACK TO CONFIRM YOUR ORDER
NAME:
HOME ADDRESS:
CITY:
STATE:
ZIP:
ZIP: HOME PHONE: CELL:
DELIVERY ADDRESS:
IF DIFFERENT - DON'T FORGET UNIT #
CITY:
DELIVERY DATES: FROM TO (please read Delivery info page!)
TO (please read Delivery info page!)IS THIS A RENTAL PROPERTY?
RENTAL AGENT OR KEY- HOLDER
AGENT OR KEY-HOLDER PHONE NO.:
ITEMS TO BE ORDERED:
QUANITY
FULL CRIB * YOU ARE REQUIRED TO USE A WATERPROOF MATTRESS PAD PORTA-CRIB PACK & PLAY .BASSINETBEACH CABANA TODDLER BED EXERSAUCER BED RAIL (1) WALKER HIGH CHAIR BOUNCY SEAT BOOSTER SEAT - NO TRAY SWING BOOSTER SEAT W/ TRAY GATE 28" - 42" CAR SEAT - INFANT GATE 29.5" - 50" CAR SEAT - TODDLER GATE 38" - 60" CAR SEAT - HIGHBACK BOOSTER SUPER YARD CAR SEAT - BOOSTER BASE ONLY RAIL NET JOG STROLLER SINGLE POTTY CHAIR JOG STROLLER DOUBLE POTTY SEAT STANDARD STROLLER INFANT BATHTUB DOUBLE S/S STROLLER MONITOR DOUBLE TANDEM STROLLER TRICYCLE W/HELMET TRAVEL SYSTEM PUSH TRICYCLE (INFANT CAR & SNAP-N-GO) CHANGING PADWAGON (FOR 2)ABC DELIVERY REQUESTED:
ABC PICK UP:
COMMENTS:
BILLING INFO: *WE REQUIRE A 50% (REFUNDABLE) DEPOSIT TO CONFIRM YOUR ORDER
CARD NUMBER:
EXPIRATION DATE:
NAME ON CARD (IF DIFFERENT)
BILLING ADDRESS:
CITY: STATE: ZIP:
YOUR E-MAIL:
*WILL BE CONTACTING YOU SOON TO GIVE YOU YOUR FINAL
PRICE AND TO CONFIRM YOUR RESERVATION.
