Water Machine Deep Clean Registration Form

Name*

First NameLast Name

Email*

example@example.com

Registered Owner (purchased through company/distributor)Non-registered Owner (purchased 3rd party FB, Amazon etc)

Distributor ID/ Buyer ID

Serial Number of Machine

found on the back of machine

Who referred you?

that way we can thank them!

My Products

Kangen Machine Deep Clean

This procedure is preformed by a trained and certified Enagic Technician. Price includes:

-Internal deep cleaning, and flushing with filtered water

-External deep clean + sanitize

-internal/external hose cleaning with soft brushes

-Enhancer tank top off

**Drop off/pick up at Haiku Marketplace included

$100.00

New FC1 Filter Change

New FC1 filter instal good for 6-9 months

$153.00 Quantity

Extra Electrolysis Enhancer

Required solution to create strong acidic and strong alkaline water

$8.00 Quantity

Westside Pick up + Delivery

Areas Include Olowau-Napili

-60-80 mile round trip

$45.00 Quantity

South Side Pick up + Delivery

Areas include Ma'alea to Wailea

-30 to 40 mile round trip

$35.00 Quantity

Central Pick up + Delivery

Areas include Kahului and Wailuku

-24 to 35 miles round trip

$30.00 Quantity

Total

$0.00

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Kangen Machine Deep Cleaning form