Date of Wedding

MM

DD

YYYY

Time of Wedding

Hour

Minute

Second

AM PM

Bride's Name *

First Name

Last Name

Bride's Phone Number *

(###)

###

####

Groom's Name

First Name

Last Name

Wedding Package Choice *

Package #1: ($1,000) 12 hours of coverage

Package #2: ($800) 8 hours of coverage

Person Responsible for Payment *

First Name

Last Name

Preferred Method of Payment (10% deposit requested to book date with remainder being due before or on wedding day) *

Cash

Personal Check

PayPal