Birthday Party Form

Parent/Guardian Contact Name*

First NameLast Name

Phone Number for Contact*

Please enter a valid phone number.

Email Address for Contact*

example@example.com

Birthday Child Name*

First NameLast Name

Age of Birthday Child*

If you were referred by someone please put their name here. (When you book your birthday party they will get a $20 gift card to BrickEd!)

First NameLast Name

Date and Time Request (if looking for a specific time please add that into the notes section below)*

Shirt size for Birthday Child*

Package Choice (see website for details, make choice below when paying)*

Basic Birthday PackagePremium Birthday PackageDeluxe Birthday Package

Drink choice: ONLY FOR PREMIUM OR DELUXE PACKAGES

Cheese Pizza Quantity: ONLY FOR PREMIUM OR DELUXE PACKAGES

6 total pizzas with purchase of deluxe or premium packages.

Pepperoni Pizza Quantity: ONLY FOR PREMIUM OR DELUXE PACKAGES

6 total pizzas with purchase of deluxe or premium packages.

Cake/Cupcake choice: ONLY FOR DELUXE PACKAGES

Vanilla Cake w/Buttercream frostingVanilla Cake w/Chocolate frostingChocolate Cake w/Buttercream frostingChocolate Cake w/Chocolate frosting

Additional information you would like for us to know.

Choose Your Package

BASIC BIRTHDAY PACKAGEIncludes: 2 hours of room rental, wall and table brick themed decorations, 30 small and large plates, 30 cups, 30 forks, 30 napkins, your dedicated party host, a birthday shirt for the birthday child, and a cooler with ice.

$249.00

PREMIUM BIRTHDAY PACKAGEIncludes everything in the BASIC BIRTHDAY PACKAGE, plus minifigures for 15 party guests, 6 pizzas of your choice (cheese or pepperoni), and 2-2L sodas or 24 pack of water.

$349.00

DELUXE BIRTHDAY PACKAGEIncludes everything in the BASIC & PREMIUM BIRTHDAY PACKAGES, plus your choice of 36 cupcakes or quarter sheet cake, and gift bags for up to 15 party guests.

$499.00

Additional Guest For each party guest in addition to the 30 provided in the room rental fee.

$9.00 Quantity

Extra Gift BagsGift bag includes: brick sunglasses, slap bracelet, brick designed pencil, brick notepad, temporary tattoo, brick candy, bag of bricks

$12.00 Quantity

Extra Birthday ShirtONLY FOR ADDITIONAL BIRTHDAY CHILDREN (i.e. twin birthdays)

$15.00 Quantity

Extra Minifigures

$3.00 Quantity

Subtotal

$0.00

Tax

$0.00

Total

$0.00

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