ORDER FORM

We respect your privacy and will never give away your information. The information you provide on this form will be used to contact you about your order, if necessary, and to provide customer service.

Do not send shoes to us with smell eliminator balls or shoe inserts, hooked together with carabiners, or packed using packing peanuts.

Instructions:

Fill out the form below. Once the form is completed and submitted a copy will be sent to your email address.
Print out the completed copy of this form that is emailed to you.
Pack order form and your shoes together in a secure package.
Mail package to the address below via any courier of your choosing. We recommend using a service that provides delivery confirmation tracking.

Mailing Address:

Yosemite Bum
1421 Edinger Ave.
Unit D
Tustin, CA 92780

CONTACT INFORMATION

First Name *

Last Name *

Email *

Phone *

Would you like to be added to our mailing list? *

Yes No

How did you hear about us? *

Are you a repeat customer? *

Yes No

How many pair/s do you need resoled?

Page 1 of 4

Pair 1 Shoe Details

Additional Instructions For Your Order:

Pair 1 Brand of Shoes

Pair 1 Model of Shoes

Pair 1 Shoes Size (US)

Pair 1 Repair Request *

Rubber Options (If you dont specify a type of rubber, your shoes will be resoled with Trax SAS) *

Pair1 Add ons
Stiff midsole Addition + $15.00
Upper Toe Patch + $15.00
Double Rand + $15.00
Stretch Option
1/2 Size Stretch
Full Size Stretch
Expedited Repair
(5-7 Business days) + $20.00*

(for information about these add-on options please refer to our service page). In order for expedited repairs to qualify for free shipping, all 5 pairs (or more) must be expedited. Partial expedited orders must pay per shipment if less than 5 pairs each.

Please Choose One

I trust you guys. If the rands need to be repaired please do so
No additional work. If the rands need to be repaired please contact me first for approval

Page 2 of 4

SHIPPING & DISCOUNT

Return Shipping Options

The customer is responsible for all shipping costs. Our default return shipping is a flat rate of $15 for UPS ground (this takes roughly 4-5 business days). Yosemite Bum only ships to US and Canada. Canadian customers are responsible for all customs fees (additional $15 per order for shipping).

We offer a climbing bum discount for -$3 per pair. You may select this discount on the order form if you are a student, retailer employee, gym employee, active/previous military service, or unemployed.

Agree to the Terms

The customer agrees that Yosemite Bum Resoles is not liable for any lost, stolen, or damaged shipments

Discount (If Applicable)

Reason for Discount

Return Shipping (the cost of sending your beautifully repaired shoes back to you)*

Shipping Address

Address1*

Address2

City*

State*

Zip*

Additional Insurance for your shoes (to protect against loss or damage above $100 - optional)

Page 3 of 4

PAYMENT INFORMATION

Agree to pricing Terms*

by checking this box you, the customer agree to all pricing specified in the Resole Order Form

Half Sole - $45

Half Sole & Rands - $65

Full Sole - $55

Full Sole & Rands $75

Card Number*

Card Verification Code*

Card Expiration Date*

Billing Information

Same as Shipping Address

Address1:*

Address2:

City:*

State:*

Zip:*

A NOTE ON RESOLES

If you experience any problems inconsistent with regular wear, please do not hesitate to contact us. We will inspect the shoes and redo the work if it is covered under warranty. *

If you are sending in a well-loved pair of shoes, please understand there are limitations to what we can repair. It’s important to note that if there are cracks in the heel rand of the rubber, there is a possibility the crack could get bigger. If the lining material of the shoe is worn, brittle, or damaged, there is a chance those shoes can come apart during the resoling process and become unusable.

Please take good care of your shoes and have reasonable expectations of our repairs. We try our best to maintain the same size and fit of your shoes. However, due to the nature of the resoling process, the fit or size can change slightly (a 1/2 size at the most). *

Page 4 of 4