<%@ Language=Inherit from Web %> Birthday Party registration

 

THE COUNTRY JUNCTION

CUSTOMER INFORMATION & INQUIRY FORM

For a birthday party, please fill out as much information as possible and SUBMIT. We will contact you and answer any questions you may have and confirm your information.

NAME: *      DATE: 
ADDRESS: * EMAIL:
CITY: *  PHONE: *
STATE: *   ZIP: * FAX:    
REFERRED BY: CELL: 
CHILD'S NAME:
DATE OF PARTY: GIRL:     BOY:
PARTY TIME  CHILD'S AGE:
AT THE COUNTRY JUNCTION @ $250.00 2 HOURS: ADDITIONAL TIME: @ 30 MIN $50.00:
HAY RIDE: (only at the farm) ADDITIONAL PONY: @ $100.00 AN HOUR
TWO PONIES @ $250.00 AN HOUR: PICTURES: 
ONE PONY AND PETTING ZOO @ $250.00 AN HOUR: COWBOY HATS: 

              (* required information)

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