2430 Avenida DeSol
Navarre, FL. 32566
850-225-0611
www.mychairrental.com

Get off your feet, pick a seat!!





Order for  _______    chairs to be delivered to   _____________________________



  
On    ________________    @  _______________


Chair Rental                 $

6% FL. Sales Tax        $

.5% Santa Rosa Co.     $  
                                                             _________
   Total                         $

                                             Less 40% retainer                    $                                (non-refundable)
                                                               _________
                        Balance                          $                           


Customer Specifications or preference

Please note any particular way you would like your chairs set up or initial below










_________ I trust  “A Chair for the Derriere”  to use their experience for set up of my chairs











___________________________
(Signature)




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Address 






e-mail


















to pay with Debit/Credit
click here
or call us  850-225-0611
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if paying by check or money order, print this page and mail to:
A Chair for the Derriere'
2430 Avenida DeSol
Navarre, Florida 32566
(please call before mailing to confirm date availability)