1. Party Date_________________________ Party Day ___Sat ___Sun Time___________

2. Name of Birthday Child__________________________ Age they are turning ________

3. Are you a Memeber? _____Yes _____No

4. Mom or Dad's Name __________________________________

5. Home Address _____________________________________________

City____________________ Zip __________________

6. Contact Phone _________________________________

7. How many guests expected __________ Age Range __________

* Special Notes _____________________________________________________________

How did you hear about us? ___________________________________________________

* A $50.00 non-refundable deposit is required within 2 days after you reserve your party.

* The price of the party for Members is $208 for a minimum of 16 kids. After 16 guests an additional $13 per child is charged. For Non-members the cost is $224 for a minimum of 16 kids and an additioanl $14 per child thereafter. The birthday child is included in this count, as well as all children who participate on the floor. NOT TO EXCEED 25 participants.

*I understand that I need to turn in a guest list to Planet Gymnastics the Friday before my party so name tags can be made for the guests.

* Under the age of 4 years old must have their parent accompany them out onto the floor.

* Parents must stay off the equipment at all times as it is designed for children.

* All Non-members must have a liability waiver turned in. All kids must participate in bare feet. As well as any adult that accompanies a child on the floor must sign a liability waiver. This will be included with the invitations if not using the invitations provided by Planet Gymnastics.

I HAVE READ AND AGREE TO THE ABOVE INFORMATION

SIGN_______________________________ DATE__________________

Please return this form ASAP.

__________________________________________________________________

OFFICE USE: Contacted prior to party on_________________________________ Deposit Received on ___________________________