Agreement Form

Name: --------------------------------------------------------
Email & Phone #: ---------------------------------------------
Date & Time: -------------------------------------------------
Location of Event: --------------------------------------------
Mis. ----------------------------------------------------------

Robert Vitaletti Ph.D.
 E-mail: doctorvitaletti@comcast.net      Phone:  303-246-7417
December 4, 2014 @ 2:45pm
1350 Lawrence Street 4E, Denver 80204
Performer will arrive approx. 30min. early to allow for setup time.

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Fees

                                                        Service Provided                                                                                                                                     Charge 

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30 min Stage Show
Plus 1hr close up

$175.00
$100.00
($25 discount)
Total    $250.00
If  Paying by check, Please Makes Check Payable to Jeff Jenson Magic