Weekend Rental Order Form

Please fill out this form in it's entirety before submitting. Your event will not be registered until you submit the form for processing. Mandatory fields are marked with a red asterisk.

Be sure you read the form carefully as you fill it out. Pertinent information is listed with each information field.

Prices reflected on this form are the standard prices for each equipment type but can vary. If you are unsure please call for verification. Also note that some items are booked well in advance and you will need to call for availability prior to ordering. Those units are marked as limited. See below.

Full Name: *

Enter your FULL name (first and last).

Billing Address: *

This is NOT the same as the Delivery Address and is used for billing purposes.

E-mail: *

Contact Number: *

This number should be the best number to contact you with. You may enter a cell phone number here or a land line number.

Date of Event: *

Please enter the date your event will take place.

Site Address: *

Enter the street location and city of your Event site location. Example: 9481 Highland Road, White Lake

Directions to the site: *

Please enter directions to the job site. Such as major cross roads and any details such as: key need to access site, etc.

Field Contact:

Name of the contact person for the site location if different than the above named person.

Field Contact Number:

A phone number for your field contact. Only necessary if you've listed a field contact person.

Equipment Choice

Please make your equipment selection from the list.

Regular Unit: $80.00

Enter the quantity of regular units that you wish to order. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Regular Unit w/ Hand Sanitizer: $105.00

Enter the quantity of regular units with hand sanitizers that you wish to order. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Handicap Unit: $130.00

Enter the quantity of handicap units that you wish to order. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Handicap Unit w/ Hand Sanitizer: $155.00

Enter the quantity of handicap units with hand sanitizers that you wish to order. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Ambassador Unit: $250.00

Enter the quantity of ambassador (flushable) units that you wish to order. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Men's Room: $275.00

The Men's Room unit is limited quantity and you will need to call to confirm availability Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Hand Wash Station: $75.00

Enter the amount of hand wash stations (sinks) that you wish to order. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Hand Sanitizer Board: $150.00

Hand Sanitizer Boards are limited in quantity, you must call first for availability prior to ordering this unit. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Portable Shower w/o Propane: $200.00

Portable Shower Units are limited in quantity, you must call first for availability prior to ordering this unit. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Portable Shower w/ Propane: $225.00

Comfort Station: $250.00

Comfort Station Units are limited in quantity, you must call first for availability prior to ordering this unit. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Shower Trailer: $2275.00

Our Shower Trailers are limited in quantity, you must call first for availability prior to ordering this unit. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Executive Restroom Trailer: $2275.00

Our Executive Restroom Trailers are limited in quantity, you must call first for availability prior to ordering this unit. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Special Event Restroom Trailer: $1575.00

Our Special Event Restroom Trailers are limited in quantity, you must call first for availability prior to ordering this unit. Standard pricing per unit shown to left of quantity box. Price can vary in some instances.

Notes:

Please enter any pertinent event information here. Such as specific times the site can be entered, placement specifics etc.

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