         
 If you wish to send a CAMO Dreamhelmet to a person on active military duty please give us their name, rank and APO mailing info below. Then just add $5.00 shipping to your order and we will do the rest. Name/Rank____________________ _____________________________ Mailing info:__________________ _____________________________ _____________________________ _____________________________ _____________________________ The DREAMHELMET is a patented sensory deprivation device. Dreamhelmet, Dreamcloud, and HiPockets are registered trademarks of James de Cordova and Dreamcloud Productions, LLC. All rights reserved. We value your comments about the DREAMHELMET and your experiences using it. Please write, fax, or e-mail us at dreamhelmet@yahoo.com | 4 ways to buy: 1. Call toll free (888) 918-5630 or 2.
Fax Order to (310) 391-1007 or 3. print and mail this order form with check or money order to address below.
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Send check or money order - or use your credit card  or 4. use PayPal - Below
Name______________________________Phone______________
Address_______________________________________________
________________________________________________________
Credit Card #_____________________________Exp. date____/____
I, the undersigned, authorize this charge to my credit card:
Signature:________________________________________________
Send to Address___________________________________________
_________________________________________________________
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Adventurer __________ How Many_______ total $ __________._____
Blue Heaven__________ How Many_______ total $_________._____
Cloud 9_______________ How Many_______ total $_________._____
Outdoorsman (Camo)___ How Many_______ total $_________._____
Rainforest____________How Many________ total $________ ._____
Stars 'N' Stripes________How Many________total $ ________._____
Teddybear____________How Many________ total $________ ._____
Exec. Herringbone______How Many________ total $______ ._____ Subtotal: $ _______.______ |
Basic Shipping and Handling in USA add $4.95 $_________.________
For each additional DREAMHELMET add $1.00$_________.________
Shipping to other countries add $6.95 $_________.________ (It's added to USA basic shipping and handling charges). For CANADA add only$3.00. Extra $5.00 to send CAMO DH to service person:$ ________._______ (optional) Total Order $ ________._______ Free Adventure Travel Purse: If you buy 3 (three) DREAMHELMETs : Tell us what color travel purse you would prefer:___________________. How did you first find out about the DREAMHELMET? __________________________________________________________
May we contact you by e-mail? yes__ no__. If yes, please provide your e-mail address____________________________________________________ |
100% guaranteed against manufacturing defects. Return within 30 days for 100% refund or exchange if defective or returned unopened. 70% of purchase price refund if returned for any other reason within 30 days.
You may print out and mail your order by using cut out address label below:
Dreamcloud Productions LLC
PO Box 5650
Santa Monica, CA 90409
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