Birthday Party Application Form

I hereby apply subject to the conditions of let for the use of facilities detailed below at the above Centre.

Applicant's Name:
Address:
Home Telephone Number:
Office Telephone Number:

Date Requested:
Time Requested:
Alternative Date:
Alternative Time:

Child's Name:
Child's Age:
Estimated Numbers Attending:

How did you hear about Kilmakee Activity Centre's parties?:		Leaflet   Word of Mouth   Newspaper advert   Child attended a previous party

The applicant hereby agrees to be bound by the conditions of hire, a copy of which he has received and by the scale of charges applicable and agrees that the delivery of the confirmation of booking shall be binding acceptance of this offer.

Form Controls: