Click above to see
our new facility video!














Parent's Information
*Last name   
  
*First name   
  
Are you a PTO/PTA Board Member?   
  Yes No
Are you a Teacher?   
  Yes No  Teacher's School  
Address   
  
City   
     State    
County   
          Zip   
*Home #   
  
Cel #   
  
Alternate tel #   
   
*E-mail     
     
Birthday Child's Information
Last name   
     
First name   
  
Child's age   
     (Day of the birthday party)
Birth date   
     
*School name   
  
Party Information
Session   
  
Date   
     
# of guests    
  

# of Invitations   

  
EXTRAS!!!

Pitchers. .
of Drinks
. .
   
   ($5.00 ea.)

Baskets. .
of Popcorn
. .
   
   ($3.00 ea.)

Bouquet. .
of Balloons
. .
   
   ($5.00 ea. set of 4)
Glo-Sticks. .
   ($2.00 ea.)
Food/Beverage. .
  Price list available upon request.
Payment Information
Payment method    
     Personal checks not accepted.
Type of Card    
  
Exp. Date    
     
Card #    
  
Type name as it appears on card
First name. .
  
Last name. .
  
Middle initial. .

  

Billing Address
Address. .
  
City. .
  
State .
  
Zip .

  

Other Information
Comments .
       
            

Thank you!
We Will be contacting you within 24 hours.



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