Birthday Party Planning Form

I want to plan a party for  (Name) ________________________________

Birth date __________________________________________________                                                                                

Parent or Legal Guardian  _____________________________                    Home phone _____________________

Work phone ___________________  Alternate phone  ____________________ 

E-mail  ______________________________

PARTY PLANNING INFORMATION

Choose your party type and fill in any applicable information.

• The Basic              $90 

  _________ guests including birthday child
  

• Party Time            $115 (+$3 more for each party guest beyond minimum of 8)

   _________ guests including birthday child
  

• Deluxe                  $150 (+$5 more for each party guest beyond minimum of 8)

  _________ guests including birthday child
  
  

  Birthday child’s favorite color ______________________
  
  

• All-Inclusive         $250 (+10 more for each party guest beyond minimum of 8
                                      + $12 more for each half hour extending beyond 1 1/2 hours)

  _________ guests including birthday child

   

              Birthday child’s favorite:

         Color ___________________  Cake  ____________________  Icing  ______________________

          Snacks  (e.g. type/brand of chips, pretzels, etc.)  ________________________________________

          Beverages  (e.g. soft drink or juice/punch)  _____________________________________________

                      Any allergies/medical conditions requiring special consideration?  _____________________________

         ______________________________________________________________________________

• Custom                 $TBD
  

Preferred party date(s)     1) _________________  2)  __________________  3)  ____________________

Preferred party times        1)  start  _______________  end  _______________

                                        2)  start  _______________  end  _______________

    3)  start  _______________  end  _______________

Payment due:  __________ + __________ +  __________  =  _____________

                                (party)      (add’l guests)   (add’l time)

*Payment may be made by check payable to Applause!  Applause! Performing Arts Center (AAPAC).*

While Applause! Applause! Performing Arts Center is committed to conducting its programs and activities
with the safety and well-being of its participants in mind, I recognize that participation in any of these programs
or activities involves some risk of injury.  I certify that I and all of my guests are able to participate in this
program with Applause! Applause! Performing Arts Center.  I further understand and agree on behalf of myself,
my heirs and assigns,  that Applause! Applause! Performing Arts Center, its directors, officers, staff, instructors,
volunteers, landlords or lessors and the Rince NoVa, in whole or in part, are not responsible for any and
all illness, injury, or damage that I or my guests may suffer as a result of our participation in this Applause!
Applause! Performing Arts Center event.

______________________________________________     ________________

signature                                                                                                date  

This form may be:

1)  Faxed to Denise Fumagali, TCRG  at 703-327-6836

                        or

2)  Mailed to Denise Fumagali, TCRG

                      25561 Quits Pond Court

                      South Riding, VA  20152