Event Request Form

Event Booking Form

Please note: upon receipt of this form, we will consider this as a booking and, if the date/time if is open, we will email a confirmation and invoice. If you have questions about our programs please call 609-737-0313 or email david@madscienceofnj.com rather than fill out this form. Thanks!

Customer Information

School or organization:

Contact name:

Position:

Day phone:

Cell phone:

Email:

Address:

Show Date(s)

1st choice:

2nd choice:

3rd choice:

VIRTUAL:

Show Topic

Topics:

Show Schedule

Before you schedule your show(s), there are a few details you should be aware of:

- We will call to confirm and receive the $125.00 deposit (P.O. customer excluded)
- Presentations are 45 minutes in length.
- If you are scheduling multiple activities on the same day, allow 15 minutes in between each one.
- Each presentation can accommodate up to 300 kids.
- A travel fee will apply.

1st Show

Start time:

Grade(s):

# Kids:

Room/location:

2nd Show

Start time:

Grade(s):

# Kids:

Room/location:

3rd Show

Start time:

Grade(s):

# Kids:

Room/location:

Additional scheduling details:

Payment Information

Send invoice to:

Promo code: