Children’s Activities Request Form Name:* First Last Contact Address: Street AddressStreet Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState / Province / RegionPostal / Zip CodeCompany:E-mail:*Phone:* Area Code - Phone Number Show InformationDate of Show*Type of Event:*Corporate PartyFamily BirthdayTrade ShowotherLocation Name:Show Address:* Street AddressStreet Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState / Province / RegionPostal / Zip CodeType of Location:HomeApartmentHotelRestaurantEvent CenterParkotherSales Person Involved:*Randy LongStart Time:* : AMPMHHMMAM/PMEnd Time:* : AMPMHHMMAM/PMCharacters Requested:*Balloon AnimalsFace PainterAir Brush TattooSantaMrs ClausChristmas CourtotherBalloon Twister:Qty Requested1234Face Painter:Qty Requested1234Air Brush tattoo:Qty Requested1234SubmitI acknowledge that I am requesting family entertainment and that this is NOT a confirmed booking until it is confirmed by the Fargo Entertainment Company.*AcknowledgeSubmitResetWord Verification: