Please Send Me The Following Luna Parc Items: --------------------------------------------------------------------------------------------------------------- Name of Item: ___________________ Finish/ Color: ____________ Quantity: ____________ Price: ____________ Total: ____________ --------------------------------------------------------------------------------------------------------------- Name of Item: ___________________ Finish/ Color: ____________ Quantity: ____________ Price: ____________ Total: ____________ --------------------------------------------------------------------------------------------------------------- Name of Item: ___________________ Finish/ Color: ____________ Quantity: ____________ Price: ____________ Total: ____________ --------------------------------------------------------------------------------------------------------------- *Please use additional sheet of paper if ordering more than 3 different items Total All Items Above: ______________ Please add 6% Sales Tax if shipping within New Jersey Shipping in the USA is FREE for orders over $200 For Orders in the US betwewen $100 and $200 please add $10 for Shipping and Insurance Costs. For Orders under $100 please add $8. Please call or e-mail for orders outside USA. Select one of three: Free Shipping: ____ $10 Shipping: ____ $8 Shipping : ____ Total With Tax and Shipping, US Currency Only Please $: ___________________ Payment Method - Circle One Option Visa - MasterCard - American Express - Discover - Check Enclosed Account number: _____________________________________________________ Billing Zip Code: ______________________ Expiration date: __________________________ Signature: ___________________________________________________________ Name as it appears on Credit Card: ________________________________________ Your E-Mail Address: ___________________________ Phone Number: _________________________ Ship To Name (if different from name above): ________________________________ Ship To Street or PO Box Address: ________________________________________ Ship To City State and Zip/Postal Code: _____________________________________ Please Fax Completed Order Form to 973/948-2062 or Mail to: Luna Parc, 22 DeGroat Road Montague, NJ 07827 Questions? Please call 973/948-2160 or e-mail Ricky@LunaParc.com Thank You! Returns of Luna Parc merchandise are rare. In the event that you want to return an item please call 973/948-2160 for authorization. Return Policy: Merchandise Returns will NOT be accepted without prior authorization. Items that appear to have been worn or used will not be accepted. A 10% (ten percent) restocking fee will be applied to the purchase price of the item(s). Shipping fees are NOT refundable.