Private Party Order Form $$ Deposit

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Complete The Form Below And Make Your $65 Deposit Securely Online

Entertainers

Quantity of Dancers

Entertainer Preference 1 View Entertainer IDs

Entertainer Preference 2 View Entertainer IDs

Time & Location

Occasion

Date of Event

1 Hour Flexible Window of Arrival

Preferred Arrival Time Within Window:

Address

Additional Location Details:

City

State

Zip Code

Special Requests And Notes

Person Booking Party

First Name

Last Name

Email

Mobile Number

Additional Information

First Name

Last Name

Mobile Number

How Did You Hear About Us?

Number of Ladies Attending?

Avg. Age Range?

Payment Information

First Name on Card

Last Name on Card

Billing Address

Billing City

Billing State

Billing Zip

Card Number

Expiration

CVC CODE

By proceeding, you are agreeing to pay all amounts due and to the terms and conditions on this website. You are paying $65 per dancer now on credit card and the remaining balance in cash upon his arrival. *

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