Name:	 First	Last

Address	 Street

	 City  State  Zip


Phone	 Home  Work


E-mail Address


I would like to order:


I would like more information on:

Full Blocks

Half Blocks

General Information


I need the Ice Sculpture on ( Date )


Please make checks payable to The Bennett-Curtis House, and mail them to:

The Bennett-Curtis House

302 West Taylor Street

Grant Park, IL 60940

Thank You and We Guarantee You Will Love Your Ice Sculpture!

Comments/Questions