Grocery Order Form

Add a little more convenience to your stay by having our services coordinate a grocery delivery services. Our shopper will go out to purchase your desired items and deliver them directly to your accommodation.  Additionally your items will be placed away neatly so when you arrive, all of your items are put in the fridge, freezer, and cupboards accordingly. Advance notice is required for this service.  Have additional questions? Contact us at 808-868-0253 or info@mauiactivityconcierge.com before submitting your form.

Guest Name (required)

Date of Arrival (required)

Accomodation Name/Address (required)

Contact Phone Number (required)

Contact Email Address (required)

Your Estimated Arrival Time (required)


  • We will strive to fulfill all your specific requests, if an item is not available, may the grocery concierge substitute items when possible?
    YesNo
  • The first stop at the grocery store is complimentary. In the event the shopper needs to make multiple stops at different stores to locate items, there is a $30.00 fee per each additional stop. Do you wish the shopper to make multiple stops to locate any items on your list? If no, the shopper may be be able to purchase all of your items.
    YesNo
  • There are 2 pricing structures to grocery services. If the shopper spends $250.01 retail of groceries or more, the fee is 40% of the total cost of the retail groceries. If the total retail cost of the groceries is $250.00 or less, there is a $90.00 fee. We will not know the total cost of the groceries until they are purchased. Do you understand these policies:
    YesNo
  • Availability of grocery items may vary. Organic is offered based on availability.If you have any additional comments, please add them in the comments section below or you can message us after submitting your grocery order form below.


  • BEVERAGES PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Coffee
    Tea
    Bottled Water
    Orange Juice
    Apple Juice
    Cranberry Juice
    Soda/Soft Drinks
    Club Soda
    ADULT BEVERAGES PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Mixers
    Wine
    Beer
    Spirits
    Limes
    Lemons
    Celery
    Other Requests
    Other Requests
    Other Requests
    BREAD ITEMS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Loaf
    Bagels
    English Muffins
    Tortillas
    Hamburger Buns
    Hot Dog Buns
    Pita
    Muffins
    Pastries
    Other Requests
    Other Requests
    Other Requests
    PASTA & RICE ITEMS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Pasta
    Rice
    Marinara Sauce
    Alfredo Sauce
    Other Requests
    Other Requests
    Other Requests
    DAIRY ITEMS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Milk
    Yogurt
    Cheddar Cheese
    Swiss Cheese
    Other Cheese
    Cream Cheese
    Eggs
    Other Requests
    Other Requests
    Other Requests
    FRESH VEGETABLES PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Avocados
    Asparagus
    Broccoli
    Carrots
    Cucumbers
    Corn on the Cob
    Eggplant
    Green Beans
    Garlic
    Lettuce
    Mushrooms
    Onions
    Potatoes
    Peppers
    Romaine Lettuce
    Squash
    Tomatoes
    Other Requests
    Other Requests
    Other Requests
    FRESH FRUITS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Apples
    Bananas
    Cantaloupe
    Strawberries
    Blueberries
    Grapes
    Kiwis
    Mangos
    Oranges
    Grapefruit
    Papaya
    Pineapple
    Watermelon
    Other Requests
    Other Requests
    Other Requests
    BEEF ITEMS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Steak
    Hamburger
    Hot Dogs
    Other Requests
    Other Requests
    Other Requests
    CHICKEN ITEMS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Breast
    Thighs
    Wings
    Whole Chicken
    Other Requests
    Other Requests
    Other Requests
    PORK ITEMS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Bacon
    Sausage
    Other Requests
    Other Requests
    Other Requests
    SPECIALTY MEATS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Veal
    Lamb
    Other Requests
    Other Requests
    Other Requests
    DELI MEAT PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Turkey
    Ham
    Roast Beef
    Salami
    Other Requests
    Other Requests
    Other Requests
    SEAFOOD ITEMS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Shrimp
    Crab
    Lobster
    Smoke Salmon
    Poke (ahi)
    Other Requests
    Other Requests
    Other Requests
    CONDIMENTS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Ketchup
    Mustard
    Mayonnaise
    BBQ Sauce
    Peanut Butter
    Jelly/Preserves
    Maple Syrup
    Honey
    Salad Dressing
    Olive Oil
    Balsamic Vinegar
    Pickles
    Olives
    Other Requests
    Other Requests
    Other Requests
    SNACKS/CEREAL PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Cereal
    Granola
    Pancake Mix
    Chips
    Salsa
    Crackers
    Pretzels
    Popcorn
    Cookies
    Nuts
    Other Requests
    Other Requests
    Other Requests
    BABY PRODUCTS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Diapers
    Swim Diapers
    Wipes
    Baby Food
    Formula
    Rice Cereal
    Other Requests
    Other Requests
    Other Requests
    ADDITIONAL ITEMS PLEASE ENTER THE BRAND & SPECIFICS QUANTITY
    Additional Requests
    Additional Requests
    Additional Requests
    Additional Requests
    Additional Requests
    Additional Requests
    Additional Requests
    Additional Requests
    Additional Requests
    Additional Requests



    Grocery Service Pricing & Terms/Conditions

    - Please let us know if it is not acceptable to replace items with a substitute in the event the brand / item(s) is not available
    - Being specific is very helpful if you wish to have certain brands or if there is anything we should be aware of
    - There is a minimum service fee of $60 or $90 fee pending location OR 40% of the total cost fee
    - $60.00 is required for South Maui or an $90.00 for West Maui and the North Shore
    - In the event item(s) are not available at one store, a $30.00 fee will apply for each additional stop
    - Service fee includes shopping, purchasing, delivery, and placing items away accordingly in the accommodation you are staying at
    - Guests are responsible to be aware of any food allergies or sensitivities and shall consume all items with the understanding of the products purchased by reading the label on items


    I understand the service terms and conditions noted above. I understand that it is not possible to prepare an advance quote for this service as each order is different. A receipt of the charge will be provided to the email address provided and the card provided will be processed the day the items are delivered. If you have questions about the delivery service, please contact us at 808-868-0253 or info@MauiActivityConcierge.com before submitting your request. Upon submitting your list we will contact you to collect a credit card to secure the booking.



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