Birthday Party Application

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1 Birthday Party Application Birthday parties are booked based on the completion of this form and a $50 non-refundable security deposit. The party is not confirmed until you have been notified. The birthday payment balance is due 10 days prior to booked party date (See payment information for more detail). You can make an appointment or check available dates by calling CONTACT INFORMATION: Contact Name: Child s Name: Current Age: Boy or Girl: Address: City: State: Zip Code: Address: Cell Phone: Day Phone: Evening Phone: Standard Member Gold Member Non Member *Applicants must provide a valid credit card to remain on file until one week after event date. PARTY SIZES: Small Party Room: $255-includes a maximum of 20 people in the room. Adults and children are included in the 20 person count. Party package includes: one Party Planner, 1 R.J. Kroc T-shirt, 20 invitations, plates, cups, napkins, tablecloths, 3 gallons of lemonade, and 20 cupcakes. No substitutions or proration of price for the above items. Large Party Room: $330-includes a maximum of 40 people in the room. Adults and children are included in the 40 person count. Party package includes: one Party Planner, R.J. Kroc T-shirt, 40 invitations, plates, cups, napkins, tablecloths, 4 gallons of lemonade, and 40 cupcakes. No substitutions or proration of price for the above items. INCLUDED PARTY OPTIONS: (Please check preferences) 1. Please pick two colors for your party decorations: Blue Red Purple Pink Bringing my own decorations (If bringing your own decorations, please set a time/date to drop them off for party planner) 2. What size T-shirt for your child? Youth: XS (4) Sm (6-8) Med (10-12) / Adult: Sm Med Lrg 3. Cupcakes: White Chocolate No Cupcakes Icing: White Chocolate 4. Are you requesting catering? YES NO (If yes, please fill out the additions menu on page 5.)

2 Pool Party: Party Time: 2 hours Small Party= $ Large Party= $ Pool Policies: 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. Children must be 48 tall to ride the large water slide. Pool rules must be obeyed at all times. Proper swim attire is required. All infants are required to wear a swim diaper AND plastic leak-proof pants over the swim diaper. Both items are available for sale at Welcome Desk. All patrons must wear proper swim attire, NO street clothes, cotton clothing, undergarments or athletic wear permitted. Anyone not wearing a swimsuit will not be permitted to swim in the pool. Party includes 1 hour of swim time. All food will be served and consumed in the last hour. In the event of a storm with lightening, the large water slide and hot tub will close. In the event of an emergency pool closure due to cleaning, your party will be rescheduled or refunded within three business days. If possible, alternate accommodations may be made the day of the party for no additional costs. Pool is open to our Members during party times. Please bring your own towels. There is a rental fee for the use of Kroc Center towels. No photography allowed in the pool or locker room areas. Pictures may be taken in the party room. A parent/legal guardian must sign a waiver for each individual under 18 attending the party. Pool Party Times: Please circle requested party time and write requested party date. Small Party Options-20 people total Saturday 12:00-2:00 2:00-4:00 2:30-4:30 Large Party Options-40 people total Saturday 1:30-3:30 / 12:30 3:30 (for an additional fee) 1:00-3:00 4:00-6:00 3:30-5:30 Requested Date: Sunday Requested Date: Sunday Last revised August 14,

3 Event Information: Initial Additional guests over the maximum allotted for each space may be asked to sit in the lobby area. You may pay an additional cost for a larger party with a 14 day advanced notification, based on availability. Each party room s maximum capacity is determined based on the appropriate Fire Marshal codes, the comfort of our guests and staffing ratios. 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. No piñatas, please. Limited decorations and gift bags may be brought in with prior approval. No whistles, please. 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 After confirming requested party date and time you must secure your requested birthday party date and time with a non-refundable $50.00 security deposit to be subtracted from the total party cost. Payment in full is due 10 days prior to booked party date. Failure to do so will result in cancellation of scheduled party and loss of deposit. 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. Quality Control: Initial The party room maximum guest numbers are total quantity (children and adults), not recommended numbers. These numbers are based on the Fire Marshal codes as well as the safety and comfort of our guests. On the day of the party, you will be asked to sign a form stating the number of party guests present at your party. It is your responsibility to abide by the maximum number of guests allowed and to ensure that number is not exceeded. Any party with additional guests will be charged a fee of $50.00 or $10 per person, which ever amount is greater, to the credit card on file. Applicants need to provide a valid credit card to remain on file until one week after event date. Cancellations: Initial Cancellations or transfers made 14 days prior to the party date are not eligible for a refund. 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: Last revised August 14,

4 Add on Items: All food & beverages add-on items are subject to 8% sales tax Item Price Quantity Total 16 Cheese Pizza (8 Large Slices) $11.95 each $ Single or Double Sliced 16 Pepperoni Pizza (8 Large Slices) $11.95 each $ Single or Double Sliced Hot Dog and Potato Chips or Assorted Fruit $4.00 each $ Chicken Nuggets and Potato Chips or Assorted Fruit $4.00 each $ Chocolate Ice Cream Cup $0.75 each $ Vanilla Ice Cream Cup $0.75 each $ Assorted Chips $1.00 each $ Assorted Fruit $1.00 each Extra Cupcakes $1.00 each $ Lemonade (Gallon) $5.00 gallon $ Fruit Punch (Gallon) $5.00 gallon Bottled Water $1.00 each $ Coca Cola(can) $1.00 each $ Sprite(can) $1.00 each $ Diet Coke(can) $1.00 each $ Additional Party Invitations $0.25 each Additional RJ birthday shirt $10.00 each Additional Party Planner $30.00 Additional 1 hour in Pool (Available Saturdays 12:30-3:30 only) $100 Sub-Total $ 8% Tax $ TOTAL $ Initial: Last revised August 14,

5 Total Cost and Payment: Item Party Package $ Security Deposit ($ ) Member Discount (Applicable to Party Room only.) ($ ) Standard Members: 5% / Gold Members 10%) Add On Total $ Miscellaneous: $ Cost TOTAL DUE: Initial $ Credit Card Type: American Express: Visa: MasterCard: Expiration: Month / Year Amount: $ Check: Check #: Amount: Cash: 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: Last revised August 14,

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