Registration Form
Party Information
Birthday Party Poekies
Name of Child *
Your answer
Age *
Kids from age 7 to 11 only
Your answer
Name of Parent *
Your answer
Phone Number *
Your answer
Email *
Your answer
Date *
MM
/
DD
/
YYYY
Time *
Time
:
Number of Kids Attending (incl. Birthday Child) *
Your answer
Please Select *
Calculate Cost
Flat rate for 8 kids: $300
Your answer
Additional kids, $30 per child
Your answer
Would you like us to provide snacks? Add $5 per child.
Your answer
Gluten free? *
Would you like us to provide decorations? Add $20
Your answer
Would you like Beginner’s Poekie Kits for party favors? Reduced rate $12.99 per kit, includes 8.25% tax.
Your answer
TOTAL: *
Your answer
Your party is confirmed upon receipt of $100 non-refundable deposit.
Please confirm a week beforehand how many kids will actually attend.
Liability Agreement
I hereby agree to indemnify and hold harmless Poekie Nook and its owner and employees from and against any and all liabilities for any injury which may be suffered by me or by my child(ren) and guests arising out of or in any way connected with participation in a Poekie Nook birthday party. In the event my child needs immediate medical attention, for any reason, including sustaining an injury during party-time, I expect to cover my child’s health-care costs and related expenses.
Do you agree to the Liability Agreement? *
Required
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