Child's Name: Child's Age:

Age Range of Guests: yrs

Aprox # of Guests:

Parents Names: Address:

City: PC: Phone:

Email:

Date Of Party (m/d/y): Time of Party:

Party Favor Orders: (Includes taxes)

Package of Egg Shakers (10) $30.75 ea - # of packages :

Package Chiquitas (10) $42.80 ea - # of packages:

Package of Kazoos (10) $34.75 ea - # of packages:

Additional Egg Shakers $3.75ea - # required:

Additional Chiquitas $5.08 ea- # required:

Additional Kazoos $4.23 ea - # required:

Please Click here to reveiw the terms and conditions of having your party at Jump Start:

I have read and agree with the terms and conditons of having my party at Jump Start.

Signature: (Please type your name here to agree with the aforementioned terms.)

Payment Information:

A $50 deposit is required to reserve your party. Please indicate your preferred method of payment: credit card cheque cash

If paying by credit card:

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If paying by cheque: Please send cheques to Jump Start Music & Movement #74-1240 Falcon Drive, Coquitlam BC V3E-2B4.

If paying by cash: Coquitlam-Please deposit an envelope with your name on it to the mailbox INSIDE the studio (beside the office) during times that we are open. (Check schedule here for appropriate times.) Maple Ridge- please give the envelope directly to a teacher 15 min before or after a class