BIRTHDAY FORM

Please provide complete information to all of the following items so that we can help plan your birthday party. Someone will contact you by phone or return email with availability within 48 hours.

Add tammy@swaders.com to your email address book to ensure your confirmation email is not blocked.

∗ Indicates Required Fields

Contact Name∗

Street Address∗

City/County∗

State∗
   
Zip Code∗

Home Phone Number∗
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Work or Cell Phone Number
-
Alternate Phone Number
-
Alternate Phone Number
-
E-mail Address∗

Best Time To Call

Date of Function

Preferred Start Time

Number of Participating Guests

Number of Non-Participating Guests

Event Type (Choose One):
         Birthday
         Sports Banquet
               Team Name
         School or Club/Organization Function
               Name of school or Club/Organization
         Other

Guest of Honor (only if event is a birthday):
Name

Date of Birth
  

Personalize your party with the choices below.
 Choose a Party:
         Ultimate Birthday Blowout
               •Choice of 3 Attractions
               •$10 Arcade Value
               •Swaders T-shirt for guest of Honor
               •Prize Wheel Spin
               $30 per participant
         Mega Birthday Bash
               •Choice of 2 Attractions
               •$8 Arcade Value
               •Prize Wheel Spin
               $25 per participant
         Classic Party Package
               •Choice of 1 Attraction
               •$5 Arcade Value
               •Prize Wheel Spin
               $20 per participant
         KidZone Party
               •All Day KidZone
               •Prize Wheel Spin
                $99 (8 participants)
                $12.50 each additional participant

Food Choices (Choose One):
         Hot Dogs & Chips
         Cheese Pizza - One Slice Per Child
         Pepperoni Pizza - One Slice Per Child

Drink Choices (Choose Up To Two):
         Coke
         Diet Coke
         Sprite
         Mr. Pibb
         Orange
         Pink Lemonade
         Sweet Tea
         Hi-C Juice Box -
         Water
         None

Please select if you would like to have additional food or drink for adult guests:
YesNo
Number of Adult Guests

Adult Food Choices
Please check the box beside the food you would like and indicate a quantity for each item selected.

Pepperoni Pizza (12" - $9.50 each):
Cheese Pizza (12" - $9.50 each):
Hot Dog with Chips ($3):

Adult Drink Choices
Please check the box beside the drink(s) you would like and indicate a quantity for each item selected.

Pitcher(s) ($5 each):
         Coke
         Diet Coke
         Sprite
         Mr. Pibb
         Orange
         Pink Lemonade
         Sweet Tea


Birthday Cake (Choose One):
Standard (Icing Balloons)

Themed Cake, $10 surcharge (Choose One):
         Happy Birthday
         Racing
         Baseball
         Golf
         Other (pending availability)
              
Bring your own cake

Birthday Cake Batter (Choose One):
         Chocolate
         Yellow
         ½ Chocolate ½ Yellow ($5 surcharge)

Cake Icing (Choose One Only For Standard Cakes):
         Chocolate (Not available on themed cakes.)
         White Buttercream
         Whipped Icing ($5 surcharge) (Not available on themed cakes. Pastel colors only.)

Message on Cake:
Number of Candles:

Ice Cream Flavor:
         Chocolate
         Vanilla
         Both Vanilla & Chocolate

Choose Your Table Ware (Plates, Cups, Napkins):
Standard Place Setting - Plates, cups, napkins (Choose One)
         Purple
         Green
         Blue
        

Themed plates, cups and napkins $10 surcharge (Choose One):
         Happy Birthday
         Racing
         Baseball
         Golf

Bringing My Own

Additional Party Add-Ons (Surcharges Apply)
Attraction(s) - $6 each
      Quantity

Goodie Bags - $2 each
      Quantity

Balloon Bouquet
      3 ct. bouquet - $5
       Quantity
      5 ct. bouquet - $7
       Quantity
      Mylar with 4 latex - $10
       Quantity
             Theme
                Nascar
                Baseball
                Golf
                Bowling
                Happy Birthday

Swaders T-shirt(s) - $16 each
      Quantity

Thank You Notes - $.50 each
      Quantity

Fun Camera(s) - $10 each
      Quantity

Additional Comments: