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% Deposit $ (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)
Name
Address
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)
to pay with Visa or Mastercard
or call us 850-225-0611
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