Swimming Pool Cover Order Form

Name:
Email Address:
Street Address:
City, State, Zip
Cover Color	Navy Blue Hunter Green
Pool Model	Bahamas Baja Bermuda Cancun Cape Coral Caribbean Carmel Chesapeake Clearwater Freeport Gulf Coast Gulf Shore Island Breeze Key West Laguna Mediterranean Montego Monterey Oahu Poseidon Rio Rockport Santa Barbara Sea Breeze St. Thomas Sun Coast Triton
Does your patio have any of the following: Jump rock, slide, waterfall, diving board or spa? If yes, please explain below:	Yes No
Explain:
Method of payment: If paying by check, please send to: CHPS, 722 Washington St. Pembroke, MA 02358 Attn: Cover Order	Credit Card Check Other