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Name of Event
Type of event
Street Number
City or Town
Province or State AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewan
Postal Code or Zip Code
Country
Estimated attendees per day?
Date of Event
Start Time
Finish Time
Preferred Set up Time
Dismantle Time
Notes
Type and Quantity of Units Needed
Name
Phone (mobile)
Company Name
Contact Person Name
Phone
Email
Cancellation fees will apply if cancelled within 72 hours of the delivery day
Tax ID #
Are you tax exempt? —Please choose an option—YesNo
Please provide tax exemption documents
Name on Card
Billing Address
Card Number
Expiration Date
CVV/CVC
Payment Amount:
Payment Frequency:
Payment Method
Taxpayer Identification #
I understand that I am responsible for providing food-quality potable water
NOTE: It is the responsibility of the event organizer to supply food-grade quality water for Quench Buggy’s distribution.
If you have questions or require assistance completing the booking form, please contact us at +1-1800-342-9882
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