First Name

Last Name

Phone Number

Email Address

How many people are in your group?

What is the date you would like to parasail?

What time would you like to arrive?

Maui-Waui (Boneless Maui rib steak sandwich on a bun) Maui-Waui (Boneless Maui rib steak sandwich on a bun) 0 1 2 3 4 5

Make this a combo (Includes choice of BBQ corn or Salad) Make this a combo (Includes choice of BBQ corn or Salad) No Yes

Boneless chicken thigh on a bun (TERIYAKI) Boneless chicken thigh on a bun (TERIYAKI) 0 1 2 3 4 5

Make this a combo (Includes choice of BBQ corn or Salad) Make this a combo (Includes choice of BBQ corn or Salad) No Yes

Boneless chicken thigh on a bun (SPICY BBQ) Boneless chicken thigh on a bun (SPICY BBQ) 0 1 2 3 4 5

Make this a combo (Includes choice of BBQ corn or Salad) Make this a combo (Includes choice of BBQ corn or Salad) No Yes

Boneless chicken thigh on a bun (TANDOORI) Boneless chicken thigh on a bun (TANDOORI) 0 1 2 3 4 5

Make this a combo (Includes choice of BBQ corn or Salad) Make this a combo (Includes choice of BBQ corn or Salad) No Yes

Tuna salad sandwich on a bun Tuna salad sandwich on a bun 0 1 2 3 4 5

Make this a combo (Includes choice of BBQ corn or Salad) Make this a combo (Includes choice of BBQ corn or Salad) No Yes

Chicken & Pork hot dog Chicken & Pork hot dog 0 1 2 3 4 5

Make this a combo (Includes choice of BBQ corn or Salad) Make this a combo (Includes choice of BBQ corn or Salad) No Yes

BBQ Corn on the cob (DILL PICKLE) BBQ Corn on the cob (DILL PICKLE) 0 1 2 3 4 5

BBQ Corn on the cob (SALT & VINEGAR) BBQ Corn on the cob (SALT & VINEGAR) 0 1 2 3 4 5

Greek Salad Greek Salad 0 1 2 3 4 5

Broccoli Salad Broccoli Salad 0 1 2 3 4 5

Pasta Salad Pasta Salad 0 1 2 3 4 5

Frozen mocha cake Frozen mocha cake 0 1 2 3 4 5

Cheesecake Cheesecake 0 1 2 3 4 5

Water Water 0 1 2 3 4 5

Vitamin Water Vitamin Water 0 1 2 3 4 5

Powerade Powerade 0 1 2 3 4 5

Nestea Nestea 0 1 2 3 4 5

Juice Juice 0 1 2 3 4 5

Juice Juice 0 1 2 3 4 5

Chips Chips 0 1 2 3 4 5

Comments