Name *

First Name

Last Name

Phone *

(###)

###

####

Date of Party

MM

DD

YYYY

Select Add Ons

Party Favor Bags ($5.00 per person)

Elite Party Favor Bags ($10.00 per person)

Large Cooler with Ice ($20.00)

24 Mini Waters ($8.00)

20 Caprisun Pouches ($9.00)

12 Cans of Coke

12 Cans of Pepsi

12 Cans of Sprite

12 Cans of Root Beer

12 Cans of Orange Soda

x 1 Medium Pizza ($15.00)

x 2 Medium Pizza ($30.00)

x 3 Medium Pizza ($45.00)

x 4 Medium Pizza ($60.00)

Ice Cream Sandwiches ($1.00 per person)

Cupcakes ($1.50 per person)