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Special Event Request Form

Please use this form to indicate your preferred event date(s) and topics(s). Once we have received your request, we will send you a confirmation letter via email.

If you are interested in scheduling an event and this request form will not accommodate your needs, please email or call 604-591-9115

Please fill in all information to help us serve you better.
Phone Number:
Cell Number:
Event Address:
Event Date:
Event Time:
No.of guests: <50   50-100    100-500    100-500   500" type=radio Name="Guests">>500

Have you ever seen a Mad Science show before?YesNo

If Yes, tell us.
Length of Event 30 min. 45 min. 60 min.
Anything else we should know?
*Keep in mind, submitting this form is ONLY a REQUEST until confirmed by a Mad Science Representative

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