Online Rental Request

Please fill in the information below, then press "Submit".
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This is a Reservation Request ONLY.  Be advised that requests are subject to availability. 
Thank you in advance for your interest. 

For quick inquiries regarding the availability of a specific item, please email us at info@goosejumps.com.

We look forward to helping coordinate your event!  Our Event Planner will contact you within 24 hours to help coordinate the details of your event.

Contact Information
	First Name	Last Name
	Organization	Email Address
	Phone Number	Alt Phone
	Event Address
	Event City	State -- State -- UT           Zip Code
Do you want to be added to our mailing list? Yes No
	We value your privacy.  We will not give your information to any other party nor will we contact you against your wishes.
about the event
	Date of Event	Set up Location is Outdoors Indoors
	Event begins at -- Time -- 09:30 AM 10:00 AM 10:30 AM 11:00 AM 11:30 AM 12:00 PM 12:30 PM 01:00 PM 01:30 PM 02:00 PM 02:30 PM 03:00 PM 03:30 PM 04:00 PM 04:30 PM 05:00 PM 05:30 PM 06:00 PM 06:30 PM 07:00 PM 07:30 PM 08:00 PM	Ground Surface -- Surface -- Grass Cement Asphalt Other
	Event ends at -- Time -- 10:00 AM 10:30 AM 11:00 AM 11:30 AM 12:00 PM 12:30 PM 01:00 PM 01:30 PM 02:00 PM 02:30 PM 03:00 PM 03:30 PM 04:00 PM 04:30 PM 05:00 PM 05:30 PM 06:00 PM 06:30 PM 07:00 PM 07:30 PM 08:00 PM	Child's age on Birthday
	Occasion -- Occasion -- Company Event School Funtion Church Funtion Birthday Wedding Reunion Other	Electrical Within 100 Ft? -- Select -- Yes No - Need Generator
	Child's Name
	Would you need an attendant? Yes No       (There is a $35/hr charge for an attendant)
equipment
	Bounce Houses: (Requests are subject to availability on the day of your event)
	1st Choice  -- Select Bounce House -- 19'x18' - World of Disney 5-in-1 Combo 19'x18' - Disney Cars 5-in-1 Combo 19'x17' - Enchanted Castle 5-in-1 Combo 15'x15' - Disney Princess Castle 15'x15' - All-Star Bounce House
	2nd Choice -- Select Bounce House -- 19'x18' - World of Disney 5-in-1 Combo 19'x18' - Disney Cars 5-in-1 Combo 19'x17' - Enchanted Castle 5-in-1 Combo 15'x15' - Disney Princess Castle 15'x15' - All-Star Bounce House
	Miscellaneous:
	Generator ($39)
	(Add $20 delivery charge for above items without the rental of a Bounce House)
how did you hear about us? -- Select -- PartyPops.com BounceCheaper.com Moonwalk-Directory.com KSL.com Google.com - Search Engine Sioto.org MSN.com - Search Engine Yahoo.com - Search Engine Search Engine - Other Word of Mouth (Referral) Business Cards Flyer Drive By Newspaper Ad Yellow Pages Family Magazine Other
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