*Your Name :

*Phone Number :

*Email:

Subject :

*Select Your First Choice of Jumper:
noneSports bounceBirthday bounceFun CastleSpace bounceJungle bouncePrincess castleDisney CarsWorld of DisneyDora the ExplorerSupermanBoxing Ring4in1 Sports comboDazzling CastlePalm TreeSpongeBobDisney FrozenCastle ComboBatmanSpidermanUnicorn Jump Unicorn Combo

*Select Your Second Choice of Jumper:
Sports bounceBirthday bounceFun CastleSpace bounceJungle bouncePrincess castleDisney CarsWorld of DisneyDora the ExplorerSupermanBoxing Ring4in1 Sports comboDazzling CastlePalm TreeSpongeBobDisney FrozenCastle ComboBatmanSpidermanUnicorn Jump Unicorn Combo

*Select Your Party Equipment:
nonecotton candy machinesno cone machinepop corn machinebubble machineadult tablesadult chairschildrens tableskids chairsgeneratorspin art machine

- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - -- - - - - - - -- - -

*REQUIRED FIELDS
EVENT INFORMATION :

*Address :

*City : , CALIFORNIA

*Zip Code :

*Date of the Event:

*Start Time: 8 AM9101112 PM123456PM

*End Time: 8AM9101112PM123456PM

*Would you like to keep the jumper Overnight?
(Additional Cost May Apply)

*Where will the Jumper be set up (i.e., Back yard, Driveway, etc.,)?

Are there any stairs, hills, narrow passages?
Yes No

*How did you hear about California Kids Jump?

Any Special Instructions?

*REQUIRED FIELDS