First Name:

Last Name:

Your Email Address:

Rental Address:

Rental City:

Rental State: Select Your State DELAWARE MARYLAND NEW JERSEY NEW YORK PENNSYLVANIA

Rental Zip Code:

Telephone (Day):

Telephone (Evening):

Fax:

Start Date/Time:

Month JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC   Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Year 2007 2008

Hour 01 02 03 04 05 06 07 08 09 10 11 12   Min 00 10 20 30 40 50   AM PM Noon Midnight

End Date/Time:

Month JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC   Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Year 2007 2008

Hour 01 02 03 04 05 06 07 08 09 10 11 12   Min 00 10 20 30 40 50   AM PM Noon Midnight

Please make your selection(s): 55 x 11 x 13 Large Obstacle Course 24 x 11 x 13 Small Obstacle Course 20 x 20 Castle 13 x 13 Castle 15 x 15 Funhouse 18 foot Slide 13 foot Slide Boom Blasters (pair)

Do you want an attendant?: Select Yes No

Preferred method of contact: Select Contact Method Phone(Day) Phone(Evening) Email

Comments:

*We require minimum rental times of 4 hours and do NOT allow overnight rentals. An attendant is not necessary unless you answered that you wish to have an attendant above.
*A power source must be located within 100 feet of where the inflatable(s) will be set up.
*The area to be used must be a flat as possible.