
	Book Your Party! - Information Form

There are two ways to plan your perfect party:

Call a Birthday Party Specialist at 804-359-1500. Or for your convenience you may e-mail us the form below.

Please complete the following information.

NOTE: Party dates and times are subject to availability. Your party will not be confirmed until Mad Science is in receipt of a deposit AND has provided you with a Mad Science Party Confirmation Form.

Hit "Submit" when form is complete

Mad Science Party Request Form


What Prompted your Visit Today?
Your Name:
Email Address (required):
Home Phone Number:
Work Phone Number:
Cell/Alt. PH Number:
Best Time to Call:
Please Call Me At:	Home Work Cell/Alt.
Street Address:
City/State:
Zip Code:

Birthday Child's Name:
Child's Actual Birthdate:
Child's Gender:	Male Female
Child's School:

Requested Party Date:
Requested Party Time:
Mad Science Laboratory	Party at Your Location

I may be interested in:
Goody Bags: Super Goody Bags Party Supplies: Party Pack Invitations Additional Activities: Bubbling Potions Cotton Candy (Lab only) Electric Lab Hovercraft (Lab only) Rocket Launch (Travel only) UV Jewelry Add'l Take-Home Project

Location: (ie XYZ Country Club)
Street Address:
City/State:
Zip:

Comments/Special Instructions:
Map to The Lab - Download a 3" x 4" map (perfect to be inserted into a Birthday Party invitation)

There are two ways to plan your perfect party:

Please complete the following information.

Hit "Submit" when form is complete

Mad Science Party Request Form