Title :

(Mr, Mrs, Miss, etc)

Name :

Address line 1 :

Address Line 2 :

Town :

County :

Postcode :

Email :

Contact phone no :

Venue name :

Address line 1 :

Address Line 2 :

Town :

County :

Postcode :

Contact phone no :

Fountain size :

Please Select Large Fountain Medium Fountain Small Fountain

Chocolate flavour :

Please Select Milk Dark White Strawberry Orange Lemon & Lime Toffee Mint Caramel

(For additional fountains then please state in additional information section with choice of chocolate flavours)

Choice of dips :

(10 dips - Large)

(8 dips - Medium)

(6 dips - Small)

NB: Strawberry Marshmallow (Extra cost)

Date fountain required

Start time :

End time :

Total number of hours :

(4Hours of rental standard, extra time at an addition charge)

Special requirements :

 i.e. No egg products, no gelatine products, don’t serve until bride & groom have arrived etc

Setup before guests arrive :

Yes No