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Rental request form

You can submit a rental request online by filling out the form below.

*** Please note that submitting this form does not guarantee your rental. We will reply with the requested information and availability. Once confirmed, we will email you a copy of your order for your approval.

bold denotes required items

 
First and Last name:

Company / School name:
Home Phone Number:
Office Phone Number:
Cell Phone Number:
Fax Number:
Email Address:
Mailing Address:
(full addresses including postal code please)
Delivery Address:
 
Event Date:
Length of rental: 7 Hours 4 Hours
Time up and going by:
Type of Event:
Description of Event:
 
Availability calendar: You can check availability of Astrojumps by clicking here
Astro Jump:
We will contact you to confirm availability
   
How did you hear about Astro Jump?
   
Additional comments / requests:
(Please specify second
choice of Astro Jump)

   


   
NOTE: Power supply must be within 50 ft. of unit, NO EXCEPTIONS.