If you would like to receive booking information, please submit the following form.

  1. Please provide the following contact information:
    Name
    Title
    Organization
    Street address
    Address (cont.)
    City
    State/Province
    Zip/Postal code
    Work Phone
    Home Phone
    FAX
    E-mail
  2. Event date:

    -- mm/dd/yy

  3. Event time:

    -- hh:mm:ss am/pm

  4. Entertainment budget range:


  5. Event location:


  6. Number of people expected to attend:


  7. Type of program(s) desired:

    Hilarious Hypnosis Stage Show
    Memory Magic Performance
    Memory Seminar

  8. Any additional information or questions you would like to submit:


    Dr. Amazing can customize programs for you.  One of his specialties is to present a hypnosis show in the evening for a large corporate party, and on the following morning he will present a memory seminar for an executive group or for a sales group.

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Last revised: December 31, 1998