Party Reservation Form

Parents must provide 2 weeks notice for cancellation.
A $100 non-refundable deposit is due at the time of booking.
The remaining balance due will be calculated on the day of the party, after all guests have arrived. This amount will be charged to the credit card on file at the end of the birthday party.
Parents are responsible for set-up and clean-up. Any decorations should be adhered with blue painters tape ONLY.
The total party time, including set-up and clean-up, is 2 hours. Any additional time guests stay at Premiere Dance Center will result in a $50 per half hour charge.
Parents are responsible for bringing party décor, beverages (Alcohol is prohibited), plates, napkins, forks, cake (or cupcakes) and party favors.
Every child attending MUST have a signed participation waiver submitted to Premiere Dance Center.

Child's Name*
DOB*
MM slash DD slash YYYY
Parent/Guardian Name*
Phone*
Email*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Party Date Option #1:*
MM slash DD slash YYYY
Start Time Option #1:*

: Hours

Minutes

AM/PM
Party Date Option #2:
MM slash DD slash YYYY
Start Time Option #2:

: Hours

Minutes

AM/PM
Style of Dance
Estimated Number of Guests (not including Birthday Child)*
Please enter a number greater than or equal to 1.
Cardholder Name
Credit Card #:
Expiration Date
MM slash DD slash YYYY
Date*
MM slash DD slash YYYY
Parent/Guardian Signature:*

By typing your full name as your signature you authorize Premiere Dance Center, LLC, to charge the card listed above for the $100 non-refundable deposit, along with the remaining balance due on the day of the party. You also acknowledge you understand and agree to abide by the policies listed above.
Name
This field is for validation purposes and should be left unchanged.

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