Birthday Party Application

Birthday Parties are booked based on the completion of this form and $50 non-refundable security deposit to our Children & Youth Department Manager. Party is not confirmed until you have been notified by the Children & Youth Department. Birthday Payment balance is due 10 days prior to booked party date (See payment information for more detail).You can make an appointment or check available dates by calling 706-922-1529.

CONTACT INFORMATION: Contact Name: _____________________________________________________________________________ Child’s Name: _____________________________ Current Age: _______ Boy or Girl: ___________________ Address: __________________________________________________________________________________ City: _____________________________State: _____________

Zip Code: ___________________________

Email Address: _____________________________________________________________________________ Cell Phone: _______________

Day Phone: _______________

Evening Phone: _______________

_____Standard Member ______Gold Member ______Non Member *Applicants must provide a valid credit card to remain on file until one week after event date. PARTY SIZES:

Small Party Room :$255-includes a maximum of 20 people in the room. Adults and children are included in the 20 person count. Party package includes: one Party Planner, R.J. Kroc T-shirt, 20 invitations, plates, cups, napkins, tablecloths, 3 gallons of lemonade, and 20 cupcakes. No substitutions or proration of price for the above items. Large Party Room: $330-includes a maximum of 40 people in the room. Adults and children are included in the 40 person count. Party package includes: one Party Planner, R.J. Kroc T-shirt, 40 invitations, plates, cups, napkins, tablecloths, 4 gallons of lemonade, and 40 cupcakes. No substitutions or proration of price for the above items. INCLUDED PARTY OPTIONS: 1. 2.

Please pick a color/colors for your party decorations: Pink What size T-shirt for your child? Youth: XS (4) Sm (6-8) Med (10-12) Adult: Sm Med Lrg XLrg 3. Chocolate or White Cupcakes? __________________ Chocolate or White Icing? ____________________ 4. Are you requesting catering? YES / NO (If yes , please fill out the add-on menu on page 5.)

Blue

Yellow

Red

Purple

The Salvation Army Kroc Center

Pool Party: Party Time: 2 hours Small Party= $255.00 Large Party= $330.00 Pool Policies:  For children under the age 8, the ratio must be 1 adult to 3 children in the pool. For ________Initial children over the age of 8, the ratio is 1 adult per 6 children in the pool.  Children must be 48” tall to ride the large water slide. ________Initial  Pool rules must be obeyed at all times. Proper swim attire is required.  All infants are required to wear a swim diaper AND plastic leak-proof pants over ________Initial the swim diaper. Both items are available for sale at Welcome Desk.  All patrons must wear proper swim attire, NO street clothes, cotton clothing, ________Initial undergarments or athletic wear permitted. Anyone not wearing a swimsuit will not be permitted to swim in the pool. ________Initial  Party includes 1 hour of swim time. All food will be served and consumed in the last hour.  In the event of a storm with lightening the large water slide and hot tub will close. ________Initial  In the event of an emergency pool closure due to cleaning, your party will be ________Initial rescheduled or refunded by the Children and Youth Manager within three business days. If possible, alternate accommodations may be made the day of the party for no additional costs.  Pool is open to our Members during party times. Private Pool Parties can be ________Initial booked privately after 6pm on Saturdays and Sundays for additional fees. ________Initial  Please bring your own towels. There is a rental fee for the use of Kroc Center towels.  No photography allowed in the pool or locker room areas. Pictures may be taken in ________Initial the party room.  A parent/legal guardian must sign a waiver for each individual under 18 attending ________Initial the party. Pool Party Times: Please circle requested party time and write requested party date.

Small Party Options-20 people total Monday 6:30-8:30

Wednesday 6:30-8:30

Large Party Options-40 people total Monday 6:30-8:30

Wednesday 6:30-8:30

Last revised March 25, 2015

Requested Date: _______________________ Friday 6:00-8:00

Saturday 12:00-2:00 2:30-4:30

Sunday 2:00-4:00

Requested Date: _______________________ Friday 5:00-7:00 7:30-9:30

Saturday 1:30-3:30 4:00-6:00

Sunday 1:00-3:00 3:30-5:30

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The Salvation Army Kroc Center

Gym Party: Party Time: 2 hours

Small Party Room= $255.00 Large Party Room= $330.00

Gym Policies: _________Initial    



Includes exclusive use of a portion of the gym during the period. Includes an additional Kroc Center Staff person to assist during gym activities. Rubber soled tennis shoes are required for play in the gym. To prevent injuries and gym floor damage, do not wear flip flops, sandals, or high heels. Parties include use of the rock wall, basketballs and one other activity. Activities to choose from include: dodge ball, volley ball, pickle ball jumping inflatable or mats for tumbling. (Please inquire about which games can be combined. Some choices take up more space than others) A parent/legal guardian must sign a waiver for each individual under 18 attending the party. Activity Choice: ________________________________________________________________

Gym Party Times: Please circle requested party time and write requested party date. Small Party Options-20 people total Monday

Wednesday

Requested Date: _______________________ Friday

Large Party Options-40 people total Monday

Wednesday

Last revised March 25, 2015

Saturday 12:00-2:00

Sunday

Requested Date: _______________________ Friday

Saturday 11:00-1:00

Sunday

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The Salvation Army Kroc Center Event Information: ______Initial          

Additional guests over the maximum allotted for each space may be asked to sit in the lobby area. You may pay an additional cost for a larger party with a 10 day advanced notification, based on availability. Each party room’s maximum capacity is determined based on the appropriate Fire Marshal codes, the comfort of our guests and staffing ratios. If you would like to book a longer party, the party package fee must be paid twice. Food orders must be placed 7 business days before your party date. Last minute food orders are not accepted. No outside food allowed in the facility (exceptions made for birthday party cake or cupcakes). For pool parties, refreshments will be served during the last hour of the party. No Exceptions. Decorations and balloons are limited due to the amount of time to setup and tear down. No piñatas, please. Limited decorations and gift bags may be brought in with prior approval from the Children and Youth Department Manager. No whistles, please. You will receive a phone call a minimum of 2 days before your party to confirm a final head count for room setup. You must leave the party at the designated end time. Please be mindful of the guests coming in for the next party.

Payment Information: _____Initial  After confirming requested party date and time with Children and Youth Staff you must secure your requested birthday party date and time with a non-refundable$50 security deposit to be subtracted from the total party cost.  Payment in full is due 10 days prior to booked party date. Failure to do so will result in cancellation of scheduled party and loss of deposit.  If payment is declined, you have one week to bring in another form of payment, or risk losing your designated party time. There is a $25.00 fee for all returned checks. Quality Control: _____Initial  The party room maximum guest numbers are total quantity, not recommended numbers. These numbers are based on the Fire Marshal codes as well as the safety and comfort of our guests.  On the day of the party, you will be asked to sign a form stating the number of party guests present at your party.  It is your responsibility to abide by the maximum number of guests allowed and to ensure that number is not exceeded.  Any party with additional guests will be charged a fee of $50.00 or $10 per person, which ever amount is greater, to the credit card on file. Applicants need to provide a valid credit card to remain on file until one week after event date. Cancellations: _____Initial  Cancellations or transfers made 14 days prior to the party date are not eligible for a refund. I agree to all the charges, terms, policies and procedures listed above and commit that my guests and myself will abide by all posted and stated rules and policies of the Salvation Army Ray and Joan Kroc Community Center. Signed: ____________________________ Date: _______________________________ Last revised March 25, 2015

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The Salvation Army Kroc Center

Add on Items: All food & beverages add-on items are subject to 8% sales tax. Item 16” Cheese Pizza (8 Large Slices) Single or Double Sliced 16” Pepperoni Pizza (8 Large Slices) Single or Double Sliced Hot Dog and Potato Chips or Assorted Fruit Chicken Nuggets and Potato Chips or Assorted Fruit Chocolate Ice Cream Cup Vanilla Ice Cream Cup Assorted Chips Assorted Fruit Full Sheet Cake Extra Cupcakes Lemonade (Gallon) Fruit Punch (Gallon) Capri Sun Apple Juice Bottled Water Coca Cola(can) Sprite(can) Diet Coke(can) Additional Party Invitations Additional RJ birthday shirt Additional Party Planner Additional 1 hour in Pool (Available Saturdays 12:30-3:30 only) Waiting space if available

Price $11.95 each

Quantity

Total $

$11.95 each

$

$4.00 each $4.00 each $0.75 each $0.75 each $1.00 each $1.00 each $20.00 $1.00 each $5.00 gallon $5.00 gallon $0.50 each $1.00 each $1.00 each $1.00 each $1.00 each $1.00 each

$ $ $ $ $ $ $ $ $ $ $ $ $ $

$0.25 each $10.00 each $30.00 $100 $50.00 Sub-Total 8% Tax TOTAL

$ Initial: ______

Last revised March 25, 2015

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The Salvation Army Kroc Center Total Cost and Payment: Item Party Package Security Deposit Member Discount (Applicable to Party Room only.) Standard Members: 5% / Gold Members 10%) Add On Total Miscellaneous: TOTAL DUE:

______Initial

Cost $ ($ ) ($ _________)

$

$

Credit Card Type: American Express: ___________________________ Visa: ______________________________________ MasterCard: ________________________________ Expiration: Month _____/ ______ Year Amount:_____________________________________ Check: Check #:______________________________________ Amount: _____________________________________ Cash: Amount: _____________________________________

I agree to all the charges, terms, policies and procedures listed above and commit that my guests and myself will abide by all posted and stated rules and policies of the Salvation Army Ray and Joan Kroc Community Center. Signed: ____________________________ Date: _______________________________

Last revised March 25, 2015

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