Name of Licensed Daycare
Street Address
City
Tax Exempt Number
(optional)
Phone Number
Name of 2nd Contact Person
Phone Number for 2nd Contact Person
Email Address of 2nd Contact Person
PLEASE NOTE - Must be Checked
All children/minors are charged admission. Staff are welcome to skate for free. Parent chaperones are not charged to observe. Parent chaperones are charged $5 admission with rentals included if they would like to skate. PLEASE INFORM PARENTS PRIOR TO ARRIVAL.
Approximate Number of Kids Attending
Age Range of Kids Attending
Approximate Number of Adults Attending
I understand a minimum payment of $240 will apply and that this package is offered to licensed daycare facilities only.
I understand A $75 cancellation fee will be charged if you do not arrive or cancel with less than 48hrs notice. All cancellations must be made by email, HighRollerSkating@gmail.com
I understand that socks are REQUIRED to use the facility & that I will be charged $2 for each pair if children arrive without socks.
Sack Lunch Policy: Children may each bring 1 sack lunch. HRSC cannot store, refrigerate, prepare, or cook any item. HRSC cannot be held responsible for any food allergies. The following items are strictly forbidden: energy drinks, soda, & candy. The concessions will be open for purchases.
I understand that rollerblades are $2 extra with packages #1-3 & that this fee is collected AT THE TIME OF RENTAL. Unlimited playground is included for children up to 5th grade.
Rollerblade Upgrade
*
Please select
I will be paying the $2 upgrade for blades, please keep track.
Please charge my guest individually at the time of rental.
I have chosen Pkg. #4, Rollerblades are included in the price.
I understand Final payment is PREFERRED before the conclusion of your event. We accept cash, VISA, and MasterCard. Personal checks will NOT be accepted. All invoices must be paid within 14 days. Invoices paid after 15 days will include a $50 late payment fee.
Party Details
Select Party Package - No Coupons or discounts will be accepted. Max playground age 5th gr.
*
Please select
Package #1 $6.00 each, Admission, Regular Skates, & Playground, Rollerblade upgrade is $2
Package #2 $7 each, Admission, Regular Skates, Playground Entry, One 8oz Drink Each, Shared Bowls of Popcorn, Rollerblade upgrade is $2
Package #3 $7.25 each, Admission, Regular Skates, Playground Entry, One 8oz Drink Each, One Slice of Pizza Each, Rollerblade upgrade is $2
Package #4 $10.50 each, Admission, Regular Skates or Rollerblades, Playground Entry, 16oz Drink, One Slice of Pizza Each, 10 Arcade Tokens, Deluxe Coupon Card, *Rollerblade upgrade included
1st Drink Choice for Kids - Pkgs. #2, 3, & 4 Only
(optional)
Please select
Pepsi
Diet Pepsi
Dr. Pepper
Mountain Dew
Diet Dew
Mist Twist
Orange
Root Beer
Pink Lemonade
Fruit Punch
2nd Drink Choice for Kids - Pkgs. #2, 3, & 4 Only
(optional)
Please select
Pepsi
Diet Pepsi
Dr. Pepper
Mountain Dew
Diet Dew
Mist Twist
Orange
Root Beer
Pink Lemonade
Fruit Punch
Pkgs #3 & 4 - Pizzas will automatically be half cheese/half pepperoni on thin crust.
Waiver Information
SAFETY RULES: Students and staff will be required to adhere to following safety rules. 1. Obey all verbal and written rules at all times. 2. No stopping or standing on the skating surface unless instructed by the DJ. 3. Remain skating in the regular skating direction without skating into the center circle unless instructed by the DJ. 4. Food and drink is NOT allowed on the skating floor, on the ledge around the skating floor, in the playground, on the video games, or in the bathrooms. 5. No skater is allowed to pick up/carry another patron. 6. Racing, chasing, and playing tag is not allowed. 7. The use of cell phones, music devices, and headphones is prohibited on the skating floor. 8. Playground Rules: No shoes or skates allowed, socks are required, no food or drink, no climbing up the slide, no climbing underneath, behind, on top of, or along the outside of playground. 9. Supervision / Discipline: it is the responsibility of the teachers, staff and chaperones to supervise and discipline patrons while using the facility. 10. All rules outlined in the school code of conduct apply. 11. All accidents and concerns must be reported to HRSC senior staff immediately.
I understand the above rules must be read to students before they exit the bus.
I understand I can always review the terms of this package/contract online.