Parent/Guardian Name *

First Name

Last Name

Phone

(###)

###

####

Birthday Child's Name *

First Name

Last Name

Preferred Party Date *

MM

DD

YYYY

Package Selection *

Mini Star

Rising Star

Super Star

Add-Ons Interested In

Party Favors

Cookies

Cupcakes

Balloon Decor

Other

I have read and agree to NC Dance Clinics’ party booking policies.