Birthday Party Request Form
Submitter Information
Name
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Party Information
Name of Birthday Person
*
The package is for ten (10) youth skaters. Would you like to pre-pay for additional youth skaters at $20 each (includes skates and food/drink combo)? If so, please note how many.
The package does not include any chaperone skaters. Would you like to pre-pay for any adult skaters at $6 each (includes skates)? If so, please note how many.
Medal Level
*
Gold
Silver
Bronze
Event Date
*
-
Month
-
Day
Year
Party Room Time Slot
*
12PM - 1:30PM (11:30AM room access; 12:30PM food service)
2:30PM - 4:00PM (2:00PM room access, 2:45PM food service)
SILVER & GOLD MEDAL PARTIES ONLY: What time would you like the 1/2 hour private lesson?
12:30 - 1:00
1:15 - 1:45
1:45 - 2:15
2:15 - 2:45
3:15 - 3:45
3:45 - 4:15
GOLD MEDAL PARTIES ONLY: What *color decorations OR *theme (general happy birthday, hockey, ice skating, or video game)?
Anything else we should know?
Submit
Should be Empty: