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Birth Afloat Rental Booking Form
Parent's Name
Parent's Name
Phone Number
Alternative Phone Number
Email
Address
Choose your Birth Pool Kit
Small Heated Wooden Pool
Medium Heated Wooden Pool
Large Heated Wooden Pool
White Mini Birth Pool Pool In A Box
White Regular Birth Pool In A Box
Blue Mini Birth Pool In A Box
Blue Regular Pool In A Box
Oasis Birth Pool
Accessory Kit Only
Choose how to receive your Pool Kit
Pick up from Ocean Shores
Pick up from Lawson
Delivered by courier
Choose how to return your Pool Kit
Drop off to Ocean Shores
Drop off to Lawson
Returned by courier
What is your EDD?
What date would you like to start your 3 week hire?
Account Name
Account Number
BSB Number
Submit Your Booking