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Birthday Party Booking Form


Mad Science Party Request Form

What Prompted your Visit Today?
Your Name: required field
Email Address: required field
Home Phone Number: required field
Work Phone Number:
Cell Phone Number:
Best Time to Call:
Please Call Me At: Home  Work  Cell
Street Address:   
City: required field
Postal Code:
Major Intersection:
Birthday Child's Name:
Child's Actual Birth Date:
Age Child is Turning:
Child's Gender: Male   
Requested Party Date:

Requested Party Time:

Expected # of Children:

Party Package:

Milliwatt    Kilowatt   Megawatt  Gigawatt               Terawatt   

Hands-on Activity:

Slime    Silly Putty    Superball (8 Yrs+)

Upgrade Activities: 

Dry Ice upgrade is included in ALL parties except the Milliwatt

Cotton Candy   Rocket Launch Radical Reactions 

Loot Bags: Yes   No

Loot Bag Quantity: 

Lab Coats: Yes   No

Lab Coat Quantity: 

If you have chosen a Megawatt, Gigawatt, or Terawatt Party, please choose your T-shirt size:

 Child Small  Child Medium  Child Large

If you have chosen a Terawatt Party, please choose your gift:

   Drag RacerShuttle    Periscope


Party Location: (If same, leave blank)

Street Address:
Postal Code:
Major Intersection:   
Comments/Special Instructions:





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