Contact Name *

First Name

Last Name

Phone *

(###)

###

####

Date of Event *

MM

DD

YYYY

Select Your Goodie Bag or Individual Item *

Basic Goodie Bag: $6 Each

Goodie Bag with Nerf Gun: $10 Each

Goodie Bag with High Exposure Water Bottle: $15 Each

Goodie Bag with High Exposure Backpack: $15 Each

High Exposure Branded Water Bottle: $10 Each

High Exposure Branded Backpack: $10 Each