Order Form & Agreement
Customer Details:
Full Name
*
First Name
Last Name
Home Address
Address in Camiguin
*
Accommodation in Camiguin
Phone Number
*
Format: (000) 000-0000.
Facebook/ Messenger Account
*
Rental Details and Fees:
Pick Up Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time
AM
PM
AM/PM Option
Return Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time
AM
PM
AM/PM Option
My Products
*
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Kodak Pixpro WPZ2
299.00 PHP
299.00
PHP
How many days?
1
2
3
4
5
6
7
8
9
10
Standard Combo
500.00 PHP
500.00
PHP
How many days?
1
2
3
4
5
6
7
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13
14
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29
30
Adventure Combo
600.00 PHP
600.00
PHP
How many days?
1
2
3
4
5
6
7
8
9
10
11
12
13
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29
30
Dive Combo
600.00 PHP
600.00
PHP
How many days?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
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20
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22
23
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25
26
27
28
29
30
Number of Reserved Days
TOTAL RENTAL FEE:
Mode of Payment
Please Select
Cash
Gcash
Bank Transfer (DM us if you prefer this)
Where did you find us?
*
Please Select
Tiktok
Facebook
Friends
Instagram
Threads
Signature
LESSEE’S SIGNATURE OVER PRINTED NAME
Government ID Front
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