Phone:
(810) 966-0552
Email:
Rodney@RodneyPalmerMagic.com
An
*
Asterisk denotes a required field
Name*
Phone Number*
Best Time to Call*
10:00 a.m. - 12:00 p.m.
12:00 p.m. - 2:00 p.m.
2:00 p.m. - 5:00 p.m.
6:00 p.m. - 9:00 p.m.
Street Address
City*
State
Zip Code
E-mail Address*
Type of Event
Baby Shower
Birthday Party
Block Party
Church Function
Community Event
Corporate Event
Day Care
Family Fun Show
Family Reunion
Grand Opening
Graduation Party
Independant Living Facility
Mall/Store Promotion
Non-Profit Event
Pre-School Event/Graduation
Vacation Bible School
Wedding
OTHER
Child's First Name
Child's Age
Date of Event*
Party Time (A.M./P.M.)
A.M.
P.M.
Number of Adults
1-5
6-10
11-15
16-20
20 or more
Number of Children
1-10
11-15
16-20
21-25
26-30
30 or more
Character Choice
Children's Magician
Family Entertainer
Corporate Entertainer
Santa Claus
We accept these forms of payment
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