| Address: | |||||
| Address: | |||||
| City: | State: | ZIP: |
|
Phone: | Home Work Cell |
|
Email: | |
| Party Choice: | ||
| 1st Machine Party flavor: | ||
| 2nd Machine Party flavor: | (If you selected a party with two machines) | |
| Party date: | |
| Party start time: |
| Extra Flavor Packs: | |
| Extra Party flavor #1: | |
| Extra Party flavor #2: | |
| Extra Party flavor #3: | |
| Extra Party flavor #4: |
| Comments/Questions: |
The following terms and conditions must be initialed by you. In the box to the right of each clause, please fill in your initials. To ensure conformity your initials will be checked against your first and last name when you submit this form.