Jack Miner Birthday Package Inquiry Form
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EMAIL: *
CONTACT (First Name):
 *
CONTACT (Last Name):
 *
PHONE NUMBER:
 *
DATE YOU WOULD LIKE TO YOUR BOOK LEARNING CENTRE BIRTHDAY PACKAGE (1st CHOICE):
 *
MM
/
DD
/
YYYY
DATE YOU WOULD LIKE TO YOUR BOOK LEARNING CENTRE BIRTHDAY PACKAGE (2nd CHOICE):
MM
/
DD
/
YYYY
PREFERRED TIME SLOT:
 *
Required
ESTIMATED NUMBER OF CHILDREN:

(Note: Our Jack Miner Learning Centre Birthday Package can accommodate up to 20 children)
 *
EXPECTED NUMBER OF CHAPERONES:
 *
ADDITIONAL DETAILS YOU WOULD LIKE US TO KNOW (e.g., accommodations, special requests, etc.):
HOW YOU HEARD ABOUT OUR BIRTHDAY PACKAGE:
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