birthdayform-8-21-12

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Birthday Party Application Birthday Parties are booked based on the completion of this form and full payment made to our Sales and Events Department. Party is not confirmed until you have been notified by the Sales and Events Department. You can make an appointment or check available dates by calling 706-364-4061.

Contact Information Contact Name: _____________________________________________________________________________ Child’s Name: ________________________________ Age: _______ Boy or Girl________________________ Address: __________________________________________________________________________________ City: _____________________________State:

Zip Code: ___________________________

Email Address: _____________________________________________________________________________ Cell Phone: _______________

Day Phone: _______________

Evening Phone: _______________

Birthday Party Packages: All Parties are 2 hours. Small Party includes 20 adults/children, one Party Master, R.J. Kroc T-Shirt, 20 invitations, 2-4x6 emailed pictures, plates, cups, napkins, tablecloths, 3 gallons of lemonade, and 20 cupcakes. No substitutions or proration of price for the above items. Large Party includes 40 adults/children, one Party Master, R.J. Kroc T-Shirt, 40 invitations, 2-4x6 emailed pictures, plates, cups, napkins, tablecloths, 4 gallons of lemonade, and 40 cupcakes. No substitutions or proration of price for the above items. o Pool Party: Large = $300.00 Small = $225.00 o Rules:  For swimming parties, for children under the age 8, the ratio must be 1 adult to 3 children in the pool. For Children over the age of 8, the ratio is 1 adult per 6 children in the pool.  Pool Rules must be obeyed at all times. Proper swim attire is required.  Party includes 1 hr of swim time. All food will be served and consumed in the last hour.  A parent/legal guardian must sign a waiver for each individual under 18 attending the party.  Children must be 48” tall to ride the large water slide.  Pool is open to Membership and Day Pass Members during party times. Private Pool Parties can be booked privately after 6pm on Saturdays and Sundays for additional fees.  Please bring your own towels. There is a rental fee for the use of Kroc Center Towels. o Gym Party: Large = $300.00 Small = $225.00 o Includes exclusive use of a portion of the gym during the period. Games to choose from include basketball, dodge ball, rock wall, volleyball, pickle ball, 4 jumping inflatable’s and mats for tumbling. (Please inquire which games can be combined. Some choices take up more space than others) o 2 Game Choices: _________________________________________________________________ o Little Da Vinci’s: Large = $325.00 Small = $250.00 o For ages 6+. Your choice of an art project: Paint Your Own Canvas, Paint Your Own Pottery, Create Jewelry, Clay Activity. o The Kroc Center must have a confirmed attendance 10 days prior to party date to ensure supplies are ordered. o Art Choice: _________________________ o Masters Chefs in the Making: Large = $325.00 Small = $250.00 o For ages 10+. o The Kroc Center must have a confirmed attendance 10 days prior to party date to ensure supplies are ordered. o Choices: Spaghetti and Meatballs, Individual Pizzas, Cupcake Decorating o Choice: _______________________ 1


Party Date and Time (Please Circle Your Choice): 

Friday, Date Requested: ______________: Party Room A (Smaller Room, 20 people max) 6:00pm-8:00pm

Party Room B (Larger Room, 40 people max) 5:00pm-7:00pm 7:30pm-9:30pm

Saturday, Date Requested:_____________: Party Room A (Smaller Room, 20 people max) 12:00pm-2:00pm 2:30-4:30pm

Party Room B (Larger Room, 40 people max) 11:00am-1:00pm 1:30pm-3:30pm 4:00pm-6:00pm

Sunday, Date Requested: ____________: (For parties that start at 1pm on Sundays, Security will escort you into the facility at 12:45pm, as the building does not open until 1pm). Party Room A (Smaller Room, 20 people max) 2:00pm-4:00pm

Party Room B (Larger Room, 40 people max) 1:00pm-3:00pm 3:30pm-5:30pm

Included Party Options: 1. Please pick a color for your party decorations: Pink Blue 2. What size T-shirt for your child? Youth: Sm Med Lrg Adult: Sm Med Lrg XLrg 3. Chocolate or White Cupcakes? ________________ a. Chocolate or White Icing? ___________________

Yellow Red

Purple

Initial: _____ 2


Event Information: ______Initial  Additional guests over the maximum allowed for each space may be refused entry OR will have to pay $5.00 each additional guest. You may pay an additional cost for a larger party with a 10 day advanced notification, based on availability.  If you would like to book a longer party, the party package fee must be paid twice.  Food orders must be placed 10 days before your party date. Last minute food orders are not accepted.  No outside food allowed in the facility (exceptions made for Birthday Party Cake or Cupcakes)  For pool parties, refreshments will be served during the last hour of the party. No Exceptions.  Decorations and balloons are limited due to the amount of time to setup and tear down. You may order a balloon bouquet on this form. You are allowed to bring in one large Mylar balloon.  Limited Decorations and gift bags may be brought in with prior approval from the Sales Department.  You will receive a phone call a minimum of 2 days before your party to confirm a final head count for room setup.  Parties are built to celebrate one birthday child at a time. For multiple birthday children, please call for pricing.  You must leave the party at the designated end time. Please be mindful of the guests coming in for the next party. Payment Information: _____Initial  Payment in full is due when application is turned in to secure your birthday party date.  If payment is declined, you have one week to bring in another form of payment, or risk losing your designated party time. There is a $25.00 fee for all returned checks.  Charges for $5.00 each additional guests over your party amount must be paid the day of the party. Cancellations: _____Initial  Parties may be cancelled or transferred 10 days before the party date to receive a refund. You will receive your refund on a Kroc Center Gift Card. There is a $25.00 fee for cancellations or transfers.  Cancellations or transfers made after 10 days are not eligible for credit. Personal emergencies must be verifiable.

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Add on Items All add-on items are subject to 7% sales tax. Item 16” Cheese Pizza (8 Large Slices) Single or Double Sliced 16” Pepperoni Pizza (8 Large Slices) Single or Double Sliced Hot Dog and Potato Chips Chicken Nuggets and Potato Chips Chocolate Ice Cream Cup Vanilla Ice Cream Cup Assorted Chips Full Sheet Cake Extra Cupcakes Lemonade (Gallon) Capri Sun Apple Juice Bottled Water Coca Cola Sprite Diet Coke

Price $11.95 each

Quantity

Total

$11.95 each

$

$4.00 each $4.00 each $0.75 each $0.75 each $1.00 each $20.00 $1.00 each $8.00 gallon $1.00 each $1.00 each $1.00 each $1.00 each $1.00 each $1.00 each

$ $ $ $ $ $ $ $ $ $ $ $ $ $

Balloon Bouquet: 12 helium and 1 Mylar R.J. Krocodile Appearance (Two Weeks in Advance) Additional Party Invitations

$12.00 each $50.00/ hour $.50 each

$ $

$

Sub-Total 7% Tax TOTAL

Initial: ______ 4


Total Cost and Payment Item Party Package $ Member Discount ($ _________) (Applicable to Party Package only. Standard Members: 5%, Gold Members 10%) Add On Total $ Additional Guests ($5 x ___ ) $

Cost

Miscellaneous: TOTAL DUE:

______Initial

$

o Credit Card Type: o American Express: ___________________________ o Visa: ______________________________________ o MasterCard: ________________________________ o Expiration: Month _____/ ______ Year o Amount:_____________________________________ o Check: o Check #______________________________________ o Amount: _____________________________________ o Cash o Amount: _____________________________________ I agree to all the charges, terms, policies and procedures listed above and commit that my guests and myself will abide by all posted and stated rules and policies of the Salvation Army Ray and Joan Kroc Community Center. Signed: ____________________________ Date: _______________________________

Initial: ______ 5


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