Name:

E-mail:

Phone No.:

(don't forget to include your area code)

City:

Number of People:

Ages (approx):

Child (1 - 11 yrs)

Youth (12 - 17 yrs)

Adult (18 - 180 yrs)

Inside Show:

Outside Show:

Time of Show:

am or pm

Date of Show:

Type of Event:

(i.e. birthday party, community event, etc.)

Are you interested in any large illusions? Yes No

Comments or Questions: