Keiki Fun Land PRINT Order Form

Name (First and Last):
E-Mail:
Company:
Street Address:
City, State, Zip:	,
Phone:
Fax:
Average age of children:
Activity Desired:	Choose 3-Horse Carousel Nine Horse Carousel Keiki Ferris Wheel Children's Octopus Clown Fun Bouncer Ten by Twelve Bouncer Birthday Cake Bouncer Race Cars Electric Train Food Concession Stand Shaved Ice, Cotton Candy, and Popcorn Machine Spaceship/Helicopter Ride Boat Ride Meteor High Striker Dunk Tank Booth Rental Tent 30-125 KW Generator Other If Other:
No. of People attending event:	Choose 5 10 20 30 40 50 100 200 300 500 More than 500
Pref. Date of Activity:
Actual Time of Activity:	Example: 1:00PM - 4:00PM
How did you hear about us?:	Search Engine From a friend Television Newspaper Rented Previously I'm not sure... Heard about you at school Heard about you at church I had a vision Other
Comments/queries:
We will accept initial deposit payment in the form of a check. Balance to be cash or money order.
Payment Type:	Check* Money Order*
Deposit Amount:
$50.00 Deposit on Carousel - 1/2 Cost of total on large rides	Phone: 671-3661
Make Deposit Checks & Money Orders Payable to: Keiki Fun Land 4 Sand Island Access Road #46 - Honolulu, HI, USA - 96819
PLEASE PRINT AND MAIL THIS PAGE TO US - Mahalo!

*The process of activating your booking will begin on receipt of check/money order.

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