Jaicee Designs, Inc.

Birthday Party Registration Form

  ONE REGISTRATION FORM PER CHILD (photocopies are accepted)

Child’s Name                                                                                 

Age                      Birthdate __/__/__  Day of Party                            

Parent / Guardian’s Name                                                                

Address (street, city, zip)                                                                 

Home Phone                                            Work Phone                      

Mom’s Cell Phone                                                               

Dad’s Cell  Phone                                                       

Email address (please print clearly)                                                      

Email address will be used for confirmation and emergency purpose ONLY

Emergency Contact Name                                       Phone                       

How did you hear about us?                                                                    

Number of children expected:                                                          

                                                                            COST:  (1^st 10 children)           $145.00 

                                                       Additional Children ____ x $10.00 each =                  

                                                                                                     SUBTOTAL                        

                                  Deposit (Due at registration and is non-refundable)     $  30.00     

                                                                                                    TOTAL DUE                        

By signing this registration form, the parent/guardian is giving permission for the registered child to attend all activities that the registered child has signed up for on Jaicee Designs campus and to be photographed while engaging in Jaicee Designs activities.  These photographs may be used for promotional purposes.

$50 deposit fee is required at the time of registration (to be applied to the total cost) to hold your date.  You may change date up to one week prior without losing the deposit.  Checks made payable to Jaicee Designs, Inc. 

Mail checks and this registration form to:  Jaicee Designs, Inc.  24310  76th Avenue West  Edmonds, WA  98026.

The undersigned adult, on behalf of themselves, family and their child, agree to hold Jaicee Designs, Inc, it agents, employees, and officials while acting within the scope of their duties, harmless from all causes of actions, demands and claims, including the cost of their defense arising in favor of the child participant, or third parties on account of personal injuries, death, or damage to property arising out of activities on the premises and in any way connected with the activities of the child participant in Jaicee Designs, Inc. activities and/or programs except for those acts of commissions which are the sole negligence of Jaicee Designs, Inc., its agents, employees and/or officials.

Parent/Guardian Signature                                              Date                

For Office Use Only

Party Theme:  ____Sewing  ____ Woodworking   ____Scrapbooking  ___ Jewelry Making  ___Other ______________________

Project Wanted:  ____________________________________________________