Registration Form
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Party Information
Birthday Party Poekies
Name of Child *
Age *
Kids from age 7 to 11 only
Name of Parent *
Phone Number *
Email *
Date *
MM
/
DD
/
YYYY
Time *
Time
:
Number of Kids Attending (incl. Birthday Child) *
Please Select *
Calculate Cost
Flat rate for 6 kids: $400
Additional kids, $32 per child
Would you like us to provide snacks? Add $7 per child.
Gluten free? *
Would you like us to provide decorations? Add $20
Would you like Beginner’s Poekie Kits for party favors? Reduced rate $12.99 per kit, includes 8.25% tax.
TOTAL: *
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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