Please write legibly

Name:

Address:

City, State, Zip:

Email:

Home phone:

Work phone:

Cell phone:

Best time to call:

If the number in your party is fewer than 4-5 you may be paired with other passengers. Parties larger than 8 can be accommodated with a multi-balloon launch. If the number in your party is 1 or 2, you may order a Private Excursion.

Number in Party (max: 8)

$250 per person

Private Excursion (max: 2):

 Yes    No    (circle one) ............ ....... ..... ...... .....$700 per flight

Estimated combined passenger weight:

Preferred flight date (3 choices):

Sunrise or Sunset (Circle one)

Note: morning weather is more predictable than afternoon; sunset flights have to be rescheduled 75% of the time.

Deposit enclosed $50 (per person):

Additional passenger name(s):

Please tell us how you heard of us (circle one):    Word of mouth      Festival      Web site   

  Other,   please explain:

I understand that hot air ballooning can be unpredictable and, under certain circumstances, a hazardous activity; that during my participation in a hot air balloon flight I will be exposed to above-normal risks; that although the pilot has taken precautions and performs safety checks before each flight, it is impossible to guarantee absolute safety; that I share the responsibility for safety in flight and have chosen to take part in this activity with these facts in mind. I state that I have no physical or other handicaps that would prevent me from safely participating in this activity and I agree to comply with the instructions of the pilot during the flight. I also understand that I forfeit any funds paid if I cancel the reservation within 7 days of the flight or do not appear at flight time at the designated launch site. I agree to supply Sky Dancer Balloons with a telephone number where I can be reached on the day of the flight in case weather conditions force rescheduling.

Signature:

Date:

Signature:

Date:

Signature:

Date:

Signature:

Date:

Signature of parent/guardian:

Date: