Attention to:* (required field) ---CherPamToriAndrew

(Please make sure that you put attention to the correct name to avoid being charged twice)

Fill up your Party Information Below:

Discussed Total quoted party price to be payed in CASH USD $* (required field)

Date of party* (required field)

Preferred Time* (required field)

One Hour window of arrival just in case unforeseen issues arise: to

Party Address & ZIPCODE too

First Name

Last Name

Primary contact cell phone

Back up cell phone

What Costume (e.g School-Girl,Maid,Cop,Fire,Hotel Manager,Pizza Delivery,50 Shades Darker,Cowboy,Dr,Delivery,Suit), Superhero/Villain-Batman,Black Panther,Captain America,Deadpool,Harley Quinn,Hulk,Joker,Iron Man,Spider Man,Super girl,Superman,Thor,Wonder Woman,)Other or just dress sexy ? :

Priority list of 3-5 dancers you like from the site, for alternates in the case issues arise ?

What type of event (Bachelor/Bachelorette , Birthday, Night Out, Divorce, Solo, Prank):

CANCELLATION FEE

Full name as appears on credit or debit card* (required field) :

Expiration date* (required field):
Month:

Year:

Security number on back or front of card* (required field) :

Full credit card billing address* (required field) :

(NOT a deposit) CANCEL-fee dollar amount up to Sales Team * (required field) (Put NUMBERS only e.g. 25,100,1000)

Zipcode* (required field) :

Phone* (required field):

Email* (required field)

Sign and date print full name*: (required field)