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)