First name:   Last name:

Address:

City: State: Zip:

Phone: Fax:

Email:

What type of event can I help you with?

(If this is for a birthday, please let me know whose birth we will be celebrating!)
   Name  
   BD (month/day/year)   Boy or Girl
   Is the show a surprise for them?             Yes No
   Package selected: {select one} Deluxe (35-45 minutes) Grand Deluxe (45-60 minutes) Platinum (To be determined)

What day will your event be held (mm-dd-yy) ?

Where will your event be held?

What time would you like the show(s) to start?

How long would you like the show(s) to last?

How did you find out about Mister Jeff?

How many people will be there?

Adults	Children

Please describe your event below with as many details as possible.
   Please include directions to the show.
   I'll be coming from the Belden Village area. (I-77)
Then hit SEND :

What is the best way to contact you?

Email  Fax  Phone 

Please note - sending this information does not mean your party is booked! I need to check my calendar, and go over the details with you. If I am available, and you choose to book the show, you will receive a written confirmation with all of the details!