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Birthday Party Request Form
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* Indicates required question
Date Form Filled out
*
MM
/
DD
/
YYYY
1st choice date for party
*
MM
/
DD
/
YYYY
2nd choice date for party
MM
/
DD
/
YYYY
Choose preferred time for party
*
11am-1pm
2pm-4pm
5:30pm-8:30pm
How many children do you expect at party?
*
Your answer
How many adults do you expect at party?
*
Your answer
What party theme are you interested in?
Your answer
Name of Parent/Guardian
*
Your answer
Address (please include the street, town & zip code)
*
Your answer
Phone #s we can reach you at
*
Your answer
Email
*
Your answer
Name of the Birthday Child & Age they will be turning
*
Your answer
Are you a member at Discovery Science Center?
*
Yes
No
Would like to discuss membership options & benefits
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