Birthday Child's Name:

Parent/Guardian's Name:

Address:

City:

Zip code/Postal code:

Email:

Confirm Email:

Phone Number:

Cell Number:

Fax Number:

Package

Select a Package Package #1 The Tornado Twister $14.95 per person + tax (adult or child) Package #2 The Hurricane $17.95 per person + tax (adult or child) Package #3 Earthquake Tremors $20.95 per person + tax (adult or child) Choose Package

Date of Party:

Day of Week:

Time Requested:

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