Birthday Party Request Form
Have your next party at Hermitage Dance Academy!
Email address *
Parent Name *
Your answer
Phone Number *
Your answer
Birthday Honoree *
Your answer
Birthday Honoree Shirt Size *
Your answer
Number of Participants (approx) *
Your answer
Number of Chaperones (Parents) Attending (approx)
Your answer
Date Requested for Party *
MM
/
DD
/
YYYY
Theme of Party *
Your answer
Which Birthday Party Package would you like to purchase? *
Teacher Request?
Your answer
Would you like to have a character show up at your party? ($75+ per character, price depends on character chosen) *
If you would like a character(s), please list character(s) requested.
Your answer
Time of Party *
Would you like to purchase additional time for your party? *
Required
Any other special needs for your party?
Your answer
A copy of your responses will be emailed to the address you provided.
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