General Info:
Select rental duration
5 Day Rental ($65)
7 Day Rental ($75)
10 Day Rental ($85)
Rented By:
Contact Phone Number:
Contact Email:
Baby's Birth Date:
Baby's First Name:
Baby's Middle Name:
Baby's Sex:
Male
Female
Weight: Lbs.
Oz.
Length:
If this is a multiple birth, please enter the other baby's names, sex and birth stats in the comments section below.
Delivery Address:
Street:
City:
State:
Zip Code:
Delivery Phone:
The following information will be printed on the Congratulations Card that will be hung on the front door:
Name of Baby's Parents:
Ordered by:
Payment Information:
Payment Type
Paypal
Check
Cash
Make checks payable to Sandra Martin, 6711 Piagetree Ln. Pearland, TX 77584
(a $10 trip charge for stork rentals may apply if outside rental area)
Send payment via PayPal to sandy@storksnmoretx.com
Name:
Street :
City:
State:
Zip Code:
Phone:
E-mail address:
Additional Comments/Questions:
We will contact you by phone within 24 hours to:
Confirm the order
Answer any questions you may have
Confirm payment information
How did you hear about us?
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