Birthday Party Reservation Request

Birthday Child:
Parent's Name:
	Street:
	City:
	State:
	Zip:
	Day Phone:
	email:
	Phone (evening)
Number of Children:
No of Children with Disabilities:
Please state special accommodations needed:
Number of Adults:
Date Requested:
Time Requested:		We allow two hours for your party: Saturdays : 11 -1 ; 1 -3 ; 3 -5; 5 -7 p.m. Sundays: 1 -3 ; 3 -5; 5 -7 p.m. Weekdays: 3-5 p.m. and 5-7 p.m.
Please mail a $20 non-refundable fee to the address shown on the next page (or $50 non-refundable fee to reserve the pavillion with campfire ready to go). Payment must be received in 7 days to hold your reservation.No reservation is final until you receive confirmation from Walters' Pumpkin Patch. Reservation is in addition to admission fees.
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