Name
Organization
Event Address
City
State
Zip
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Email
Mobile Phone
Text notifications okay?
Other Phones
Home Phone
Office Phone
Fax Number
Referred By
Select...
Bing
Direct Mailing
Friend
Google
Other
Past Customer
Phone Book
Print Ad
Radio
Yahoo
Event Name
Start
End
Surface
Select...
Grass - Allow Stakes
Gravel/Pavement/Concrete
Delivery Type
Select...
Delivery
Special Delivery/Park Ect
Table/Chair Drop Off
Tax Exempt?
No
Yes
Would you like to add the optional Damage Waiver Insurance that covers accidental damage
to rentals but does not include theft?
Yes, I would like to add the 10% Damage Waiver Insurance
No, I do not want the Damage Waiver Insurance
Where will inflatables and tents be set up?
Front yard
Back yard
Side yard
Commercial location
N/A (only Chairs/Table rental)
Location Type?
Residential
Commercial
Park
Contact Address
Same as Event Address
Address
City
State
Zip
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Volunteers
Selected Rentals
1
CONNECT A SHOT
Foam Mats
Remove
Moonwalks & Bounce Houses
Slides & Combos
Inflateable Interactive Games
Obstacle Courses
Tents
Tables & Chairs
Dunk Tank
Generator
Foam Machine
Cotton Candy
Coupon Code
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