Order Form - Please Print and send or bring in with your Items First Name _____________ Last Name__________________ Address __________________________________________ City______________________ State ________Zip _______ Phone # (____)___________________ Email Address______________________________________ Item to be dipped: Only send the items you wish to be dipped. Firearms must be completely disassembled. ________________________________________________________________________ __________________________ Scopes will have to be fully submerged in water and so no warranty will be issued. Please fill out and include the Scope Waiver form and send or bring in with your items. Pattern Requested: ________________________________________________________________________ ________________________________________________________________________ Sure Grip __________ Comments or Special Instructions: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Chameleon Camo and Hydrographics 1. 2. 3. 4. 5. 6. Send us the above submission form or email prior to shipping your items to us. Print and fill out the Order Form and send it signed with your item. (If dipping a scope, please include the scope waiver form) Package your item well; we will no be responsible for damaged items received. Ship your item with FedEx or UPS. Make sure to insure your package. For your convenience there is a shipping label below. Just cut it out and tape it to your package. Call us if you have any questions and we will call you when we receive your packag. Thanks for your order. Chameleon Camo and Hyrdographics (601) 807-0344 Cut along line Chameleon Camo and Hydrographics C/O Roy Farmer 405 Willow Street Vidalia, LA 71373 (601) 807-0344