Horrocks Market Curbside Pickup Order Form

****IMPORTANT****
Unfortunately, due to lack of demand, Curbside Pickup will be CANCELLED on Friday 6/5. Friday will be the last day that we are processing orders. Thank you so much for understanding. If you still need assistance with your grocery order, please call us to see how we can help!

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Place your Curbside Pickup Order now! If you are interested, please read all the details and fill out the form below.

DETAILS:
• Available 8AM to 8PM daily
• $5 service fee
• No minimum order
• Credit card only

If purchasing ALCOHOL, please note:
• You must be 21 years or older with valid identification.
• The individual who called in the order must be present at the time of pickup.
• Valid ID must be shown at time of pickup.
• If ID does not correspond with individual and payment information, we will not complete the order, and your alcohol will be refunded.

Feel free to email horrockscurbside@gmail.com or call us at 616.455.7998 with any questions or concerns.
Email address *
First Name *
Your answer
Last Name *
Your answer
Phone Number *
This is how we will contact you to let you know your order is ready and process payment. Please ensure it is the best number at which to reach you.
Your answer
Garden Center Items
Please list the items and quantities you wish to include in your order.
Your answer
Candy/Popcorn Items
Please list the items and quantities you wish to include in your order.
Your answer
Produce Items
Please list the items and quantities you wish to include in your order.
Your answer
Deli Items
Please list the items and quantities you wish to include in your order.
Your answer
Dairy Items
Please list the items and quantities you wish to include in your order.
Your answer
Meat Items
Please list the items and quantities you wish to include in your order.
Your answer
Other Items
Please list the items and quantities you wish to include in your order.
Your answer
Alcohol Order Items
Please list the items/quantities you wish to include in your alcohol order.
Your answer
Alcohol Purchase Confirmation
By checking this box, you are confirming that you are 21 years or older with valid identification. You understand that the individual who placed the order must be present at the time of pickup. If you are unable to provide valid ID upon pickup, we will not complete the order and your alcohol will be refunded.
Substitutions? *
If we are unable to fill one of the items listed in your order, would you like us to try to substitute with a similar product?
Thank You For Your Order!
Once you have submitted this form, we will process your order. We will give you a call when we have your order prepared to review item availability, substitutes (if needed), order total, and collect payment via credit card.

After payment via phone is complete, you will be able to pickup your order at:
Horrocks Market
4455 Breton SE.
Kentwood, MI 49508

When you arrive at the store, please call 616.455.7998, ask for Horrocks Curbside, and we will bring your order to your vehicle.

If your order includes alcohol, please remember:
• You must be 21 years or older with valid identification.
• The individual who called in the order must be present at the time of pickup.
• Valid ID must be shown at time of pickup.
• If ID does not correspond with individual and payment information, we will not complete the order, and your alcohol will be refunded.

Feel free to email horrockscurbside@gmail.com or call us with any questions or concerns.

Thank you! We are all in this together. <3
A copy of your responses will be emailed to the address you provided.
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