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    
   
Invitations    
   
Choose  
Your Meal   
  
Glo-Sticks  
     Glo-Stick
EXTRAS!!!

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

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

Bouquet. .
of Balloons. .
   
    ($5.00 ea. set of 4)

Large Birthday. .
Cake Upgrade. .
   
   ( $14.00 ea. )

 * Birthday cake is provided for party guests.

 * Please choose this option if you want
 * to offer cake to non-party guests
 * (i.e. siblings of guests and parents).
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 .
       
            


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