PARTY ORDER FORMPARTY ORDER FORM
mdm.rockinjump.com BIRTHDAY PARTY FOOD ORDER FORM - GAITHERSBURG PARTY ORDER FORM Please fill out and email to: [email protected] NAME: __________________________________________ PHONE: _________________________ PARTY DATE: ____________________________________ PARTY TIME ______________________ SERVING TIME (APPROX.): _________________________ PARTY ROOM: ___________________ TO ENSURE YOUR FOOD IS DELIVERED ON TIME, PLEASE MAKE SURE TO ORDER AT LEAST 48 HOURS IN ADVANCE. NOTES: ROCKIN' PARTY PACKAGE BUILD YOUR OWN PIZZA TWO PIZZAS & TWO 2 LITER SODAS LARGE PIZZA W/ YOUR CHOICE OF TOPPINGS $40.00 + TAX (20 SLICES) – QUANTITY: _______ $14.00 + $1 PER TOPPING – QUANTITY: _______ CHEESE _______, MEAT _______, VEGGIE _______, COMBINATION _______, HAWAIIAN _______, PEPPERONI _______, SAUSAGE _______, BEEF _______, GRILLED CHICKEN _______, BACON _______, ADDITIONAL PIZZAS $14.00 + TAX (10 SLICES) – QUANTITY: _______ CHEESE _______, $17.00 + TAX (10 SLICES) – QUANTITY: _______ MEAT _______, VEGGIE _______, HAWAIIAN _______, OLIVE _______, TOMATO _______, PEPPER _______, MUSHROOM _______, CANADIAN BACON _______, EXTRA CHEESE _______, ONION _______, JALAPENOS _______, PINEAPPLE _______, BANANA PEPPERS _______, COMBINATION _______, $10.00 + TAX (SMALL) – QUANTITY: _______ SAUCE ONLY _______, ROCKIN' PARTY EXTRAS CHICKEN POPPERS (15 PIECES) $8.25 +TAX QTY _______ CHEESE STICKS (8 PIECES) $6.00 +TAX QTY _______ CHOOSE TWO DRINK SELECTIONS FROM BELOW CHOICE OF RANCH, BLUE CHEESE OR PIZZA SAUCE ROCKIN' SOFT DRINKS CHOICE OF RANCH, BLUE CHEESE OR PIZZA SAUCE PEPSI _____ DIET PEPSI _____ DR. PEPPER _____ SIERRA MIST _____ ORANGE SODA _____ 2 BOTTLES OF WATER (1 LITER) _____ CAPRI SUN (10 PACK) _____ ORDER RECEIVED BY: BEVERAGES PEPSI (2 LITER) $3.00 +TAX QTY _______ DIET PEPSI (2 LITER) $3.00 +TAX QTY _______ DR. PEPPER (2 LITER) $3.00 +TAX QTY _______ SIERRA MIST (2 LITER) $3.00 +TAX QTY _______ QTY _______ ORANGE SODA (2 LITER) $3.00 +TAX BOTTLED WATER (1 LITER) $1.50 +TAX QTY _______ CAPRI SUN (10 PACK) $6.00 +TAX QTY _______ (Serving time will be within 10 minutes of desired time)
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