Name *

First Name

Last Name

Phone *

(###)

###

####

Pool Size *

Regular (76") - $225

Mini (65") - $225

Optional Add-ons

Tarp - $20

Birthing Ball (small - for moms under 162 cm) - $20

Birthing Ball (medium - for moms between 162-177 cm) - $20

Birthing Ball (large - for moms over 177 cm) - $20

Delivery/Pickup *

Delivery (fee dependent on location)

Pickup (free)

Due Date *

MM

DD

YYYY