Birthday Party Contract

Birthday Party ContractThank you for choosing the Kernersville Family YMCA for your child’s birthday party. We love celebrating and work to makeevery party fun, safe and full of memories! Please review and provide the following information to help us make your party asuccess. We’re happy to accommodate special set-up requests and ask that you diagram in detail on a separate sheet of paper.If you have any questions, don’t hesitate to contact: Jane Evans, Birthday Party Coordinator at 336-996-2231 ext.6425.CostMembers: $185.00 Potential Members: $250.00Price IncludesFacility rental, party planner, food and drink, and party supplies.RegistrationChild’s Name: _____________________________________________________________________________________________Parent/Guardian’s Name: ______________________________________________________________________________KERNERSVILLE FAMILY YMCA1113 W Mountain Street, Kernersville NC 27284P 336 996 2231 F 336 996 8605 www.kernersvilleymca.org A United Way AgencyOur Mission: “Helping people reach their God-given potential in spirit, mind and body.”Birthday: _____________________Date: __________________________Address: __________________________________________________________________________________________________________________________________________Telephone: Home ____________________________________ Cell: _____________________________________Requested Event Date: _____________________________ Number of guests:____________________Day and Time (please select first choice):Friday: 6:00-8:00 ___ Saturday: 12:00-2:00___ or 3:00-5:00___ Sunday: 2:00-4:00___Work: __________________________Party Activity (please select one)Water Park___ Gym___ Game Room___ Pool___ Bounce House___ Zumba Dance ____Playzone (recommended for children under age five)___If you selected the pool or water park above, please indicate below a second choice in the case of inclement weather.Game Room___ Gym___ Playzone___The playzone, which includes an indoor playground, is the main party room for participants of all ages. Each birthday party willlast two hours with one hour in the party room and another hour in the location designate above. You’re also invited to rentanother portion of the Y at the cost of $50 per hour if that suits your needs. Note, if renting the pool or waterpark, this area isstill open to members during the party with the exception of Sunday evenings.We ask that the host parent/guardian attend the entire party. To book your party, please return full payment and signedcontract two weeks before the desired date.Food and Drink OrderIncludes juice boxes, as well as four hand-tossed, one-topping pizzas from Domino’s.Toppings Desired: Pizza 1 _______________________________________________________ Pizza 2 ____________________________________________Pizza 3 _______________________________________________________ Pizza 4 _____________________________________________There will be a $10 charge for any additional pizzas. Additional Pizzas:___________________________________________________________

Office Use Only: Front desk, please select one belowMember ____Potential Member_____KERNERSVILLE FAMILY YMCA1113 W Mountain Street, Kernersville NC 27284P 336 996 2231 F 336 996 8605 www.kernersvilleymca.org A United Way AgencyOur Mission: “Helping people reach their God-given potential in spirit, mind and body.”

All patrons of the Kernersville Family YMCA are required to observe the following rules and regulations. The Kernersville FamilyYMCA’s posted pool rules will be enforced by the Aquatic Staff during the party. NO ALOCHOL OR TOBACCO PRODUCTS AREPERMITTED IN OR ON YMCA PROPERTIES.Facility Policies1. The YMCA will not tolerate any form of harassment of or by an employee, vender, member, or guest based on religion,race gender, national origin or disability.2. Profanity, abusive language, threatening behavior, verbal threats or fighting is not permitted on YMCA property.3. Alcoholic beverages, tobacco products or illegal drugs in any form are not permitted on YMCA property.4. Carrying a concealed weapon on the premises is prohibited.5. Proper dress is required.6. The YMCA is not responsible for lost, stolen, or misplaced items.7. Cell phones may not be used in bathroom/locker room area.8. Special needs dressing rooms are located near both pools.9. Soap showers are required prior to entry into the pool or whirlpool.10. The Men’s Locker Room and Women’s Locker Room are for Members/Guest age 19 and above. Members under the age of19 must use the Youth and Family Locker Rooms or special needs room.11. Violation of any of these policies or any other policies posted on the Kernersville Family YMCA website or contained in theCode of Conduct and Guidelines for Discipline may result in the suspension or termination of YMCA privileges.Signed contracts and payments are required a minimum of two (2) weeks in advance of your facility rental dates.Your party includes:• 15 pizza plates• 15 cake plates• 30 napkins• 15 juice boxes• 3 table cloths• 10 balloons• 4 Large one topping pizzas• Use of the Party room and one activity area• Party planner to assist you in making your party a successWe are happy to assist you to meet any needs for extra food or supplies, as well as to meet any special requests for yourparty. We look forward to working with you to make your child’s party a day to remember!I agree to be present and accountable for the birthday party and actively engage in all activities. In the event I cannot bepresent, responsibility for the birthday party will be assigned to (print name) ___________________________________.Signature:_____________________________________________________________Date: __________________________________________Printed Name: ______________________________________________________KERNERSVILLE FAMILY YMCA1113 W Mountain Street, Kernersville NC 27284P 336 996 2231 F 336 996 8605 www.kernersvilleymca.org A United Way AgencyOur Mission: “Helping people reach their God-given potential in spirit, mind and body.”