Reservation Request

Full Name*

First NameLast Name
Delivery Address*
City*
E-mail*
Phone Number*
***Party Date & Time (Pickup is Next Morning)****

MonthDayYear
HourMinutesAM/PM Option
Water Slides
Dry Slides
My Moonwalk First Choice
My Moonwalk Second Choice ( As a Backup Only)
Concessions and Misc.
1st Item
Concessions and Misc.
2nd Item
Party Options

2 Tables & 12 Chairs $401 Table & 6 Chairs $25Early Friday Delivery $40Keep Everything a 2nd day for $80Insurance for damage to equipment $5Bubble machine with Solution $25
Setup Location

GrassConcreteIndoorsBack YardFront Yard
Additional Message:
How should we send your confirmation?

TextEmail
THIS IS NOT A CONFIRMATION. YOU WILL RECEIVE YOUR CONFIRMATION TO YOUR EMAIL OR TEXT WITHIN 24 HOURS.

There is now a $5 gas surcharge on all orders.

By clicking on the SUBMIT BUTTON, you and all of your guests agree to hold harmless Moonwalks 4 Less, their owner and all operators from any and all incidents.
Should be Empty: