The 2023 Irem Shrine Circus will be held April 10th to April 16th, 2023.

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: Fax:
Special Needs:
Wheelchairs limited to four (4) per show
 
Preferred Seating: Balcony Main Floor  
 
Wednesday 10:00 A.M. (4/12)   Total Attending   # of Lunches      
  # of Wheelchairs   # of Buses   # of Vans
Thursday 10:00 A.M. (4/13)   Total Attending   # of Lunches      
  # of Wheelchairs   # of Buses   # of Vans
Friday 10:00 A.M. (4/14)   Total Attending   # of Lunches      
  # of Wheelchairs   # of Buses   # of Vans
Amount Paid:

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

Irem Shrine Circus Office
22 East Union Street
Kingston PA 18704

Fax: 570-714-0305

Email: iremcircus@gmail.com

Deadline for this information is March 9th, 2023.

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