The 2017 Irem Shrine Circus will be held April 17th to April 22nd, 2017.

It is our hope that your Elementary School Class will attend as our guest.

A box lunch is available, consisting of a Juice Box, Hot Dog and Fresh Apple.
The cost is $4.00 each and must be ordered and paid for in advance.
The lunch will be delivered to your seats!



School Name:
Address:
 
Contact Person:
Phone:
Special Needs:
(Wheelchairs limited to four (4) per show)
 
All school shows begin at 10:00am
Wednesday (4/19)  -  Approx # Attending:   Buses:   Lunches:
Thursday (4/20)  -  Approx # Attending:   Buses:   Lunches:
Friday (4/21)  -  Approx # Attending:   Buses:   Lunches:
Preferred Seating:   Main Floor   Balcony
Amount Paid:

Please complete this form online, then print it. Mail or fax the printed form to:

Irem Shrine Circus Office
22 East Union Street
Kingston PA 18704

Fax: 570-714-0305

Deadline for this information is April 1st, 2017.

Print this Form