Pakket150 - Showerrent

Pakket150

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Naam*
Adres en huisnummer*
Inclusief huisnummer
Postcode*
Postcode
Woonplaats*
Email*
Telefoonnummer*
Mobielnummer
Wat wilt u huren?*
- Douche 77,5 x 77,5
- douche 90 x 90
- Zorgdouche
- Mobiele badkamer
Waar moet de douche geplaatst worden?*
Welke waterpunten zijn aanwezig?*
- Warm Water
- Koud Water
Wat is de afstand tussen de douchecabine en de aansluitpunten?*
Wat is de verwachte huurperiode?*

Voorbeeld: 14-04-2011 t/m 14-05-2011
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