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Party Request Form
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After-School Programs
Birthday Parties
Programs at the Mad Science Laboratory
Special Events
Workshop Information
Contact Information
Contact name:
Email:
Primary phone:
Cell phone:
Work phone:
Best time to call:
Please call me at:
Primary
Cell/alt
Work
Street address:
City:
State:
Zip:
Birthday Child's Information
Child's name:
Turning age:
Actual birthday:
Gender:
Boy
Girl
Party Location
Party at:
My location
The Mad Science Lab
If the party is at your location include the following location & directions
Location & address:
Attendees
Approximate # of children:
- Select one -
15 or less
16 - 20
21 - 25
26 or more (includes 2nd instructor)
Youngest age:
Oldest age:
Party Date & Time
Option 1 date:
Time:
Option 2 date:
Time:
Option 3 date:
Time:
Party Details & Upgrades
Party package:
Moon
Planet
Sun
Galaxy
Add-On Activities
- Optional -
All-You-Can-Eat Cotton Candy
Dry Ice & Bubbling Potions
Rocket Launch
Hovercraft Rides (Only available in The Lab)
Laser Light Show
Other add-ons:
Slime
Mad Science Putty
Superball
Invitations
Qty:
Goodie Bags
Qty:
MS
T-Shirts
Qty:
Lab coats Qty:
Comments & Additional Information
Use the box below to give us any other pertinent information.
Basket