Space Walk Repair Request Form
located at 450 31st. Street Kenner, LA 70065
Full Name:
*
First Name
Last Name
Please fill out this form if you would like us to repair your inflatable!
Company Name:
*
Address:
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
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State
Zip Code
Email Address:
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Have we completed repairs for you before?
*
Yes, Space Walk has completed repairs for me before
No, this is my first repair with Space Walk
I am not sure
How many Inflatables will you be dropping off to us for repair?
*
Please Select
1
2
3
4
5
6
7
8
9
10
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable: (please be specific as possible)
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected and a $100 re-roll fee will be administered.
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable:
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected, REPAIR WILL NOT BE DONE, and a $100 re-roll fee will be administered. (PRO-TIP: Make sure your hose has been drained prior to rolling up)
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable:
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected and a $100 re-roll fee will be administered.
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable:
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected and a $100 re-roll fee will be administered.
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable:
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected and a $100 re-roll fee will be administered.
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable:
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected and a $100 re-roll fee will be administered.
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable:
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected and a $100 re-roll fee will be administered.
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable:
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected and a $100 re-roll fee will be administered.
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable:
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected and a $100 re-roll fee will be administered.
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
Name of Inflatable:
*
Please describe what you want repaired on your inflatable:
*
PLEASE NOTE: Any area that needs to be repaired, please list here. If it is not listed, we are not responsible for repairing that area.
I acknowledge that if my inflatable is not DRY and CLEAN, it will be rejected and a $100 re-roll fee will be administered.
*
YES, My Inflatable is Dry and Clean
upload pictures of your damaged areas:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Once the repair is completed, customer has up to 30 business days to pay AND pick-up the repair. After 30 business days, customer will be charged $25.00 per day in storage fees until picked-up. (effective 1-1-23)
*
I acknowledge and agree
Back
Next
If you are out of state and would like to ship your inflatable to us, we could help set up shipping and receiving!
Yes, I would like help sending my unit(s) to berepaired!
No, I will be dropping it off in person!
If you are dropping off in person, please select an accurate drop-off time:
After the repair(s) are completed, would you like us to email you the invoice?
*
Yes, I would like to pay via email invoice
No, I rather pay at pick-up
Thank you for your business!
Once submitted, our repair team will be notified. For any questions, please call 800-622-6026
Submit
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