MommyTime Indoor Playground
Visit us at 4412 Electric Rd. Roanoke, VA 24018 Tanglewood Mall On Second Floor Call: (540) 355-0788 for more information.
Parent's Name
*
First Name
Last Name
Child's Name
First Name
Last Name
Child's gender
Please Select
Boy. Paper supplies color
Girl. Paper supplies color
E-mail
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Party Deposit
$
75.00
Phone Number
*
Date Of Party Date/Time. Pick an even time slot.Party room is reserved 1:45 min.
*
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Month
/
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Birthday Party Size
*
Please Select
Bring Your Own Food, $75 + Admission Fees ($10 or $15, or min $80)
8 Kids Package $175 (Pick a color, 1 Cheese and 1 Pepperoni, water bottle, juice, Coca-Cola or Sprite)
16 Kids Package $325 (Pick a color, 2 Cheese and 2 Pepperoni, water bottle, juice, Coca-Cola and Sprite)
Color of paper supplies (Only for the 8 kids or 16 kids package)
Please Select
Yellow
Pink
Red
Blue
Purple
Mixed (Write colors in additional message box)
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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Additional Message: $75 Non -refundable Deposit is required to secure date, time and room.
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