Full Name
*
First Name
Last Name
Phone Number
*
Emergency Contact
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
Street Address
*
Apartment / Unit / Gate Code
City
*
ZIP Code
*
DElIVERY WINDOW
8-10 AM National City
10-12 PM PARADISE HILLS
12-2 PM SPRING VALLEY
2-4 PM CHULA VISTA
Delivery Access
*
Leave at door
Knock
Call when outside
Gate code
Concierge / office
Other
Delivery Notes
Would you like your half your cases delivered cold?
*
Yes (+$5)
No
How many extra cases would you like added to your monthly delivery?
*
1 extra case (+$8)
2 extra cases (+$16)
3 extra cases (+$24)
None
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WATER BOYZ PLAN TIER - Chose Your Monthly Plan
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BASIC
5 cases
$45.00
$
45.00
Quantity
1
2
3
4
5
6
7
8
9
10
PLUS+
8 cases
$65.00
$
65.00
Quantity
1
2
3
4
5
6
7
8
9
10
PREMIUM
12 cases
$99.00
$
99.00
Quantity
1
2
3
4
5
6
7
8
9
10
VIP
(15 cases, cold or alkaline, first-priority)
$149.00
$
149.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Signature
Embassador Code
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