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First name
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Last name
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Email
Phone
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Date picker- ONLY SUNDAYS ARE AVAILABLE!
(Required)
Juices ONLY come in bundles - Choose your amount
(Required)
3 Juices
$18
8 Juices
$48
10 Juices
$60
How many of which flavor (You will NOT get double charged, this is only to ensure you get the right amount of each flavor!)
Cucumber Cool
$0
Strawberry Refresher
$0
Melon Lover
$0
Pineapple Express
$0
Product 5
$0
Ginger Shot
$0
Citrus Shot
$0
Sweet Shot
$0
What time on Sunday are you picking up? This much be filled out 72 hours before Sunday pick up
(Required)
10:00 am
1:00 pm
Sign to confirm you will pick up your order
(Required)
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I will be there on time!
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