Deathray Protection Free Mask Request
After you fill out this mask request, I will contact you to go over details and availability before the order is completed. If you would like to contact me directly or schedule a pickup at Deathray HQ please contact Rick at
Have you requested a mask before?
This is my first request
I have requested one or more masks in the past
How many masks would you like?
Please enter the number of masks
What color(s) would you like to order?
Dark color / Black
Please specify any customizations needed (kids size, large, custom size, etc) or special color requests
Mobile number (if txt message is needed)
Preferred contact method
Shipping Costs & Donations
If you are unable to pay for shipping I will send masks at no charge. Estimated shipping costs can be sent directly to me via PayPal or Venmo. Donations are also appreciated and help continue this free service for others.
Venmo: DeathRayRick or PayPal.me/deathray
(Street number, State, zip)
Thanks you for being safe
Send me a copy of my responses.
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This form was created inside of Death Ray Laser Systems.