Coastwide Amusements

Equipment Booking Form

 

 Name

 

Address 

 

Home Phone No Mobile Phone No 

 

Customers Email Address

 

Delivery Address 

 

Is access to the delivery site difficult ?  If yes please give details below

Ie: Steep Driveway or path, More than 3 stairs, Narrow doorway or path <750mm

 

Function Date Start Time Finish Time

 

Preferred Delivery Time   Preferred Collection Time

Please allow at least a 1 hour time frame to allow our drivers flexibility ie: 10-11 am

 

Is this function a surprise function  If so please supply us a safe contact No

 

Equipment Required

 

           18 CD Juke Box                                x Pinball Machines

           Digital Juke Box                               x Video Games

           Digital Juke Box with Karaoke      

           Music Activated Lights

 

                           Any Comments and Questions

 

                                                                                                           

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Booking Form

Sorry this form is still under construction

and is not working at this time

Please visit our other site HERE and use the booking form on that site or you can call our friendly office on 02 4329 4666 for assistance