Bicycle World Of Louisiana

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Shipping request form for Ironman New Orleans

Your Information

Today's Date*:

Your Name*:

Email*:

Phone Number*:

Alt. Phone Number:

Fax Number:

Return Shipping Information

Recipient Name*:

Shipping Address*:

City*:

State*:

Zip Code*:

Bike Manufacturer*:

Bike Model:

Please insure bike and contents for*:

Additional Comments/Instructions:

Requested Services

Event you are attending*:

New Orleans Half Ironman 70.3

Service Plan*:

Receive, build, re-box and ship $175.00 plus actual freight charges
Tune up, receive, build, re-box and ship $250.00 plus actual freight charges
Return only, I will be responsible for getting my bike to the event; Re-box and ship $100.00 plus actual freight charges
Deliver at event only, I will be responsible for getting my bike home after the event; Receive, build, and deliver at event $100.00

Note: Cost of shipping will be actual UPS shipping charge. Expect return shipping charge to be similar to charge for shipping it to us.

Billing Information:

Card Type*:

Card Number*:

Card Exp. Date*:

Verification Code*:

Billing Zip Code*:

I understand that there is an inherent risk associated with shipping a bicycle. I release Bicycle World of Louisiana from any claims regarding the loss, damage, and/or delay of my bicycle and/or other items packed with the bicycle..

Agree to terms and conditions*:

Yes

Verification:

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