Bear Bottoms Diapers are cleaned and sanitized in our large commercial laundry facility, with per wash testing, 180 degree sanitizing temps, washing, sorting and free delivery. See and feel the difference with Bear Bottoms.

� Bear Bottoms Diaper Service Application

Thank you for choosing Bear Bottoms Diaper Service. By filling out the form below you will be well on your way to starting our service. We will then call or email you to set-up your pre-birth delivery or first delivery date. It�s that easy!

Please read carefully the Terms of Service before completing this application.
Fields marked with * are required information.

I have read and accept the
Terms of Service:� 		*
Name (First/Last):� *
Spouse/Partner Name:�
Address:� *
City (see service area):�
 *
Postal code:� *
E-mail:� *
Home Phone:� *
Work Phone:�
Cell Phone:�
Best time/place to contact you: �
How did you hear about us?�
Expected Due Date
(if applicable):�
Will you require a pre-birth �
installment of diapers?: �		 Yes� No
Age (in months) of
Child(ren) for service:�
Will you be purchasing Buddi Covers?: � Yes � No Unknown

Preferred method of payment:�		 Pre-authorized Payment ��� Visa
Mastercard ��
(Pre-authorized payment is the most secure method of payment, at no extra cost, fees apply if choosing to pay by credit card.
Your account will be charged monthly in advance)
Invoice type: Please indicate here if you would prefer a paper invoice.
Yes � No
Your invoices will be e-mailed to you monthly, prior to billing.
Questions or comments:�
By clicking below you have applied for the service and agreed to the terms within. We will contact you shortly. Thank you for choosing Bear Bottoms Diaper Service.


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Telephone: 519-634-8600����
Toll Free: 1-877-423-2726

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