Laser Flash - Reservation Request Form

Your name (first & last):
Your telephone number (required):

Your street address:
City:	State: Zip:

Your e-mail address:
Add e-mail address to our promotions list:	Yes

Type of reservation you would like:	Hassle Free Party Build A Bash Super Bash Free Team Party play laser tag only overnight lock-in team building exclusive rental of the entire Laser Flash facility

Group name or first name of guest of honor:
How old will the guest of honor be?
Maximum number of players you will invite including the guest of honor:

Preferred date:	Time:
Alternate date:	Time:

Do you want invitations mailed to you?	yes no I will pick them up I will down load them from this website

What kind of cake do you want?
Flavor of cake:
Icing color:
Icing type:

Are you interested in ordering pizza?	yes no
Pizza is ordered when you arrive and we will cook it fresh while you are playing laser tag.

If you have a coupon, enter 4-digit code:

Additional Notes:

This is only a REQUEST. No reservation is actually generated until you speak with someone at Laser Flash and make a deposit. If you do not hear back from Laser Flash within 24 hours, please call (317) 571-1677.