BP_ Request Form

Evergreen Cultural Centre
Birthday Party Request Form

	*	Today's date: (YYYY/MM/DD)

	*	Name:

	*	Daytime Phone:

	*	Email:

	*	Mailing Adress & Postal Code:

	*	Birthday child's name:

	*	Birthday child's age (turning):

	*	What type of Birthday Party are you interested in? Art PartyDance PartyDrama Party



		Preferred date & time of party. In the event that this space is not available, please provide two more dates & times in the spaces below.

		Preferred date & time: second choice

		Preferred date & time: third choice

		How many guests will be invited?

		What is the age range of the birthday party guests?

		Please use this box if you have any special requests.