Dear Mom or Dad,

Please out all the information below, send it to me and your child will automatically be a member of "Krazy Keith's Sekret Magik Klub." There are no initiation fees or dues and lots of free stuff!

As a member, your child will receive in the a free personalized autographed membership certificate, a free magic booklet and a free magic trick!!! Fill out this form and send it to me today!

Parent's First and Last Name:
E-mail Address:
Child's First and Last Name:
Child's Birthday (mm/dd/yy):
Address:
City:
State:
Zip Code:
Telephone (with area code):
Comments:
Please enter

PERFORMANCE INFORMATION REQUEST     References Available Upon Request