Reservation Pre-Authorication Form

    Attention to:* (required field)

    (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):

    How many Dancers?

    CANCELLATION FEE PER PERFORMER

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

    Credit card number* (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) :

    DEPOSIT for the PHONE CALL RESERVATION ONLY as a service, not the dancers deposit (NON-REFUNDABLE) * (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)

    Proof of Partial Payment (this is your card) (NON-REFUNDABLE) : (Please use Mouse or Touchpad for signature below)

    Being the cardholder or Corporate Officer, by signing this proof of purchase, I understand and agree to the terms set forth in this agreement, agree to pay, and specifically authorize to charge my credit card, for the products or services provided. I further agree that in the event my credit card becomes invalid, I will provide a new valid credit card upon request, to be charged for the payment of any outstanding balances owed. I furthermore confirm that I have received all services and goods to satisfactory conditions.

    I Agree to the Terms and ConditionsI Agree to the Terms and Conditions

    I Agree to the Refund PolicyI Agree to the Refund Policy

    This is a Cancel-Fee or Deposit Form below!

    This is up to EVENT Planner

    This is up to EVENT Planner

    This is up to EVENT Planner