YOUR Full Name *

Phone *

Name of person you are nominating

Phone number of nominee

Share with us the unique story story of the family you are nominating. What challenges have they faced, and how would a free bounce house experience at our indoor fun center bring joy to their lives? Please include birthdates. *

Would you like us to keep the nomination confidential? *

Yes

I understand this is not a bounce house rental at a private residence and the party will be held at the indoor facility located at: 18155 Vintage Ct, Unit C, Middletown, CA 95461

Yes

By submitting this form, be aware that you may receive text messages to finalize your nomination and/or promotional text messages. Reply STOP to the phone number to be removed at any time. Toads Jump may disqualify your nominee due to loss of contact and will no longer contact you.

I understand the above statement *

Yes

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from Toads Jump.