Language
English (US)
Spanish (Latin America)
Birthday Cake Request form
Free of charge to you!
Parent/Guardian Information
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
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Child's Information
*
First Name
Last Name
Birthday
*
-
Month
-
Day
Year
Date
They are turning ____ years old
*
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Please tell me a little about the birthday party theme!
*
Upload a picture of your cake inspo or your child's drawing of their dream cake! We will try our best to replicate it perfectly!
*
Browse Files
Drag and drop files here
Choose a file
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Cake flavor preference
*
Vanilla
Chocolate
Strawberry
Funfetti
Carrot
Other
*If choosing "other" please tell me the desired flavor and we will try our best to make it!
Icing flavor preference
*
Vanilla buttercream
Chocolate buttercream
Cream cheese
Strawberry buttercream
Other
*If choosing "other" please tell me the desired flavor and we will try our best to make it!
Number of servings needed (number of people needing to be fed)
*
*a 6 inch cake will serve 6-12 people, an 8 inch cake will serve 8-12 people
Please type your preferred message for the top of the cake (in your preferred language)!
*
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Does your child have any food allergies or dietary restrictions?
*
Yes
No
If "yes", Which of these apply? (check all that apply)
Nut allergy (peanuts, tree nuts)
Dairy allergy/lactose intolerance
Egg allergy
Gluten/Wheat allergy (celiac or sensitivity)
Soy allergy
Food dye sensitivity
Other
*If "other" please specify below
How severe is the allergy?
Mild (can be near the food, but shouldn’t eat it)
Moderate (avoid eating, but not life-threatening)
Severe (anaphylaxis risk, must avoid any contact)
Please list any safe alternatives or special instructions.
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Preferred date/time for cake delivery
*
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How would you like to receive your cake?
*
Delivered to my child's SOAR campus
Delivered to my home or place of celebration
Please write the address of your desired delivery
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Agreement
*
I understand this cake is provided at no cost through Birthdays by Madi
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By submitting this form, I acknowledge and consent that Birthdays By Madi may take and use photographs from my event for marketing, promotional, and related purposes. I understand that these images will only be used by Birthdays By Madi and will never be sold or shared with third parties.
*
Yes, I give consent - I allow Birthdays By Madi to take and use photos of my child and/or their cake.
Yes, *cake only* - I allow Birthdays By Madi to share photos of the cake, but not my child.
No, I do not consent - Please do not take or use photos of my event or cake in any way.
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