Order Form

Phone *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Rubber *

Match to original

Vibram XS Grip

Vibram XS Grip 2

Vibram XS Edge

No Edge (XS2)

Sanitize and Deodorize ($10 extra)

Yes Please!

Nope!

I have read and accept the terms of service *

https://www.westcoastresoles.com/terms-of-service

Yes

Do you have any additional shoes orders to submit? *

Please send a separate order form for each pair.

Yes

No

My shoes are hole free and in resole-able condition *

If you are unsure if your shoes are in a repairaable state please contact us with photos at info@westcoastresoles.com. Mail in clients are strongly encouraged to send photos before sending their shoes.

Yes

No