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Click here to print the Le Chocolate Fountain Rental Agreement

Click here to print the Le Chocolate Fountain Rental Agreement FOR Los Angeles Area

 

Loss History

First Name:   M.I.:   Last Name:

E-mail:

Contact Phone Number (with area code):

Coverages/Limits of Liability

Event Address:

City:   State:   Zip Code:

Time:

Date of Event:

Number of People:

Type of Event:

Rating/Underwriting

Package:

Fruit Dipping Option - $2/person (mentioned above)

(Additional Dipping Options)
  Strawberries:
Pineapple:
Apple Slices:
Bananas:
Pretzels:
Marshmellows:
(Skewered with Pretzel Sticks)
Grapes:
 

Other(any requests considered):


Additional Baked Goods Dipping Options
(can bake just about any request)


Mini-biscotti-$9/dozen extra:
(Plain, Hazelnut, Almond, Cranberry-Almond)


Peanut-butter cookie balls-$9/dozen extra:


Short-bread cookie balls-$9/dozen:
(Plain, Hazelnut, Almond, Cranberry-Almond)

If you have any comments or questions, please enter them here. Then Click "Submit."

				
PLEASE NOTE: By submitting this form, information will be transmitted to our representatives who will contact you by e-mail or phone with your quote information.