Birthday Party Registration

Let's Book Your Party!
Parent/Guardian Name*

First NameLast Name
Child's Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
Parent/Guardian E-mail*
example@example.com
Parent/Guardian Number*
What Month Would You Like To Book Your Party?*
Please list two desired Saturday Dates For Your Event :)
Please confirm the day and time here!
How did you hear about LPAC Birthday Parties?

Complete Your Booking*

Party Deposit

This deposit will go toward your party total and is non refundable. If we are unable to accomodate your date request you will receive your deposit refund back on the same payment method(excluding the processing fee)!

$50.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Medical Release and Participation Waiver For The Birthday Child: Parents, legal guardians of minors and adults waive the right to any legal action for any injury sustained on Level Up Performing Arts Center Property or event resulting from normal class/physical activity or any other activity conducted by the participant before, during or after class time. I have my own medical insurance to cover any and all medical bills or related bills that may arise from the nature of the activity. I release Level Up Performing Arts Center from all financial responsibility from any expense that is incurred for any unfortunate situation that may occur. I also consent to my child's photo being used in any images or marketing by Level Up Performing Arts Center. *
Should be Empty:

Let's Book Your Party!

Now, let's customize your party...