Form

Form
Client Information
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Event Details
Date

MonthDayYear
Date
Start Time

Hour Minutes

AM/PM Option
End Time

Hour Minutes

AM/PM Option
Address of Event

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number of Guest
Theme/Colors of Event
Upload Theme Inspiration:
Bar Service (Specifics will be on the Service Agreement after the Scheduled Consultation)

Mini Cake BarCandy Fruit BarChocolate Strawberry BarMini Donuts BarMini Waffles BarNacho/Chips BarMini Pancakes Bar
Add-Ons/Notes (These options includes extra fees)

Custom SignageThemed Decor SetupExtra Service TimeExtra Cake FlavoringExtra Candy Flavoring
Additional Notes or Request:
Food Allergy Notice & Acknowledgment

Food Allergy Disclaimer: Exquisite Rose is not responsible for any allergic reactions or issues related to food allergies if we are not notified via email at ExquisiteRoseGifts@gmail.com, the allergy is not disclosed within this agreement, or the allergy is not communicated to our staff at the bar stand during the event. Please list any below:
Food Allergies:
Signature
Should be Empty:

Client Information