EmailMe Form - Self Booking Form

Client Name *

First Last

Name of parent or adult booking the show

Your relationship to child

If you are booking me for a birthday, communion, christening, etc., what is your relationship to the celebrant? For example, mom, dad, grandma, aunt etc.

Organization

IF you are calling for a company, school, day care, scout pack, church or other organization--what is the name of your organization

Name of child

If this is a birthday party, communion, christening, etc. what is the name of the celebrant?

Occasion *

(e.g. Birthday, Communion, Purim, Christening, Blue & Gold, Fun Day etc.)

Age of child

If this is a birthday party, communion, christening, etc. how old is the celebrant?

Your Mobile Phone No. *

### - ### - ####

Alternate Phone Number *

### - ### - ####

Another number that I can reach you at on the day of the party. If the party will be at home, provide your home number, otherwise a good number would be your significant other's cell.

Your Email Address *

Number of kids at the party *

Please try to be as accurate as possible, but I realize you are guessing. You can also give me a range e.g. 15-20

Age range of the children *

I'm trying to understand the CORE age range of the children e.g. 3-9, or 4-12?

Where will the party take place? *

(e.g. Home, Akbar Restaurant, Anthony Michaels Pizzeria etc.)

Address *

Street Address City State / Province / Region Postal / Zip Code Country

What is the address of the party? If the party will be at home, please provide your home address and an apartment number in the STREET ADDRESS.

Date of Party *

MM / DD / YYYY

What time do you want the magic show to START *

HH : MM AM/PM

What time does your party START *

HH : MM AM/PM

What time does your party END *

HH : MM AM/PM

How did you hear about me? *

IF you found me using Google--WHAT did you type into the Google search box?

Names and ages of any siblings

E.g. Christopher 9, Natalie 7

Why did you decide to hire ME?

Additional information

Is there anything else you'd like me to know, or anything that is special or unique about your party, location, address, guests?

Cash Payment Acknowledgement *

I understand that the fee is payable in CASH (NO CHECKS) immediately upon completion of the show.

Please check box to confirm that you will pay in cash (NO CHECKS) immediately upon completion of the show.