Date for Appearance:_______________ * Please Read the Note at the bottom of this page

Number to Attend: ______________ Showtime(s):________-_______&________-________

Person Making Request: __________________________Title: _____________________

Name of School: _____________________________________________________

Address of Location:_______________________________________________________

City:___________________Zip:_______On site Contact’s name:__________________

On-site Contact’s Phone:____________________Alternate Phone:__________________

Students in Attendance Pre-K___ K___ 1^st___2^nd___ 3^rd___4^th___5^th___6^th___

Check all grades attending the show

School Shows:     ( ) " Giving Back with Ronald McDonald™" (schools only, ages 5 to 12) NEW SHOW

                   ( ) The Friendship Adventure with Ronald McDonald™ (schools only, ages 5 to 12)

                   ( ) On the Inside with Ronald McDonald™ (schools only, ages 5 to 12)

                       ( ) Book Time with Ronald McDonald ™ (schools only, ages 4 to 12)

       ( ) Ronald Makes it Magic ( a magic show tailored to any audience)

Special Instructions/Notes/Directions:______________________________________________________________

__________________________________________________________________________________________

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*Note: This is only a request and it does not guarantee your event has been booked. You will receive confirmation once the show has been booked.

Please fax request(s) to 713-223-2798. Please call Sue Hinkin @ 713-223-2788 for any further questions or e-mail at shinkin@moroch.com

To find out more information visit Ronald at www.mcdonaldshouston.com