Contact Us

*Full Name

*Email Address

*Delivery Street Address

*City

*State

*Zip Code

*Billing Address same as Delivery Address *Billing Address same as Delivery Address Yes No

Separate Billing Address - Street, City, State, Zip Code

*Cell Phone (000-000-0000)

House Phone (000-000-0000)

Company Name

*Location Type *Location TypeHouseBusinessHotelConvention CenterOther

*Inside/Outside *Inside/OutsideInsideOutside

Skirt Color Skirt Color Black White Grass Hula

*Date of Party

*Party Start Time

*How many guests will you be serving? *How many guests will you be serving?1-2526-5051-7576-100101-150151-200200+

*Liquor *LiquorYesNo

*Flavor *FlavorApple CiderBananaBlue HawaiianBlue RaspberryCherry BombColaDreamsicleFeelin' no PainFroseGreen Apple (Appletini)Groombay SmashHurricaneMai TaiMangoClassic MargaritaMudslideNeutral BaseOrange PowerPeach BelliniPina ColadaPina Colada SELECTRum RunnerSangriaStrawberryStrawberry-BananaSummertime LemonadeTKO-Tropical KnockoutWatermelonWhite Russian

*Quantity - Number of Mixes *Quantity - Number of Mixes123456789101112Other - list below.

If Other Quantity - how many mixes?

How you heard about us How you heard about usRepeat CustomerReferralSaw Vehicle/TrailerGoogle SearchFacebookInstagramLinkedInSnapchatOther - list below.

*If Other - where else did you hear about us?

Unusual Delivery Circumstances ($50 if second delivery person required) Unusual Delivery Circumstances ($50 if second delivery person required) Stairs Steps Steep Driveways Uneven Pavement

Special Circumstances Special Circumstances Same-day ($50 Additional Charge Applies) Early Delivery or Late Pickup (6pm - 8am: $50/hr)

Additional Information