CircusWest Performance Bookings Request Form

(* denotes required field)

* Contact Name

* Organization

Position/Title

* Phone

Cell

Fax

* Email

Name of Event

* Date(s) of Event

* Time(s) of Event(s)

Event Description

Acts Desired
 Aerial silks Trapeze Acrobatics Acrobalance Stilts Acrobatics Juggling Unicycles Unicycling

* Name of Facility / Venue

* Address of Facility Venue

Stage Dimensions

Ceiling Height

Other Facility / Venue Information / Description