Making Birthdays Memorable Since 1986

Full Name:
Email (double check):
Home Phone:
Work Phone:
Address:
City/Town:
State/Province:
Zip/Postcode:
Date of Party (mm-dd-yy):
Time that you'd like show:
Is the party at your home? If not, where?:
How did you find out about Scott?:
Approximate number of children:
Birthday Child's Name:
Birthday Child's Age:
Additional comments:
Please Select Your Party Package:

Yes! I live in the Hampton Roads area and I want Scott Wagoner to make my child's birthday party
magical and memorable. I want to see my child perform unbelievable magic, I want to hear all our guests
laugh with delight, and I want to feel like the greatest parent on the planet!!!
I understand that to reserve Scott Wagoner for my child's party, I simply need to fill out the following
information. (After my party information is submitted, I'll receive an electronic confirmation within 2 business
days. Should there be a scheduling conflict, Scott will be in touch with me personally as soon as possible).
(Please fill out this form only after you've requested info 
and know which party package you're interested in.)
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