BIRTHDAY PARTY OPTIONS ORDER FORM BASIC INFO: Birthday Child s Name: Gender: Birthdate: Any Special Needs: Any Allergies: Primary Contact Name: Relationship to Child: Primary Contact Address: Mobile Phone Number: Email: Dates / Times Considering: 1 st Preference: 2 nd Preference Anything Else We Need to Know: CHOOSE ONE: Fun-Tastic LEGO Party - $225 Ages 4+ 1-1½ hour LEGO Themed Party Assistance with Pizza, Cake, etc. Up to 12 Guests Additional Guest $11 LEGO Motor-Mania Party - $295 Ages 6+ 1-1½ hour TECHNIC Motorized Party Assistance with Pizza, Cake, etc. Up to 12 Guests Additional Guest $14 *A trained NextGen SmartyPants Teacher will arrive for a pre-arranged 2-hour time slot. Parties are typically held during late-morning, early-afternoon, or late-afternoon on a Saturday or Sunday. Teachers will bring up to 30,000 LEGO Bricks, Motors, Gears, Laptops, ipads, Lesson Plans, and any other materials that they will need to lead a successful and memorable birthday party for your child. 1
Fun-Tastic LEGO Party Choose A Theme (Only One Please): Angry Birds Batman Black Panther Cars (The Movie) Chima Chronicles of Narnia Coco Daniel the Tiger Dinosaurs Disney Princesses Dora the Explorer Dr. Seuss Ferdinand Finding Nemo Fingerlings Frozen Happy Feet Harry Potter Ice Age (The Movie) Jurassic Park Justice League LEGO CITY LEGO Friends LEGO Mosaics Lion King Lord of the Rings Madagascar Mickey Mouse MineCraft Mini-Figure Mania Minions Monster High Moana Mulan My Little Pony Nexo Knights Ninjago Paw Patrol Pirates of the Caribbean Pokémon Power Rangers Ratatouille Shimmer & Shine Skylanders Spider Man SpongeBob SquarePants Star Wars SuperHeroes Super Mario Bros Teenage Ninja Turtles Toy Story Unikitty Wild America Wonder Woman LEGO Motor-Mania Party Choose A Theme (Only One Please): Ages 6+: Hungry Alligator Ages 6+: Roaring Lion Ages 7+: Crossbow Ages 7+: Catapult Ages 7+: Dragster RaceCar Ages 7+: Helicopter Rescue Ages 7+: Mars / Space Rover Ages 8+: Star Wars: Droid Hand Ages 8+: Star Wars: Space Chase Ages 8+: Star Wars: X-Wing Fighter Ages 9+: Remote Control Car Ages 9+: Soccer Robotics 2
**Here are additional party-planning options for you. The locations ask that you contact them directly. LOCATION FYI, these fill quickly and often require 8-weeks notice! For your convenience, we have partnerships with each of the following to provide you free space for your child s LEGO party; however, they ask that you purchase food through them. We ve held many successful parties here and highly recommend each of them! COSI, West Hartford Center Savoy Pizzeria, West Hartford Center Flatbread Pizza, Canton The following locations do not provide food options; but have also been fantastic partners, providing great service, beautiful space, and are also highly recommended: Children s Museum, West Hartford Westmoor Park, West Hartford ~$180 includes museum admission ~$150 includes kitchen & outdoor area Unitarian Church, West Hartford ~$80 includes kitchen NextGen SmartyPants, Canton Another Location of Your Preference - may not be a residence At the time of reservation for your location, send in your completed form, and we ll start planning for your party! Locations usually need at least 8-weeks notice; NextGen SmartyPants requires at least 4-weeks. A quote will be provided to you, and payment for the reservation will be required at that time. Adjustments to number of children, etc., will be happily made as needed: Call: (860) 272-4000 Fax: (860) 541-5830 Email: hello@nextgensmartypants.com 3
Birthday Child s Name: Party Date / Time: Quantity Extended PARTY PACKAGE Fun-Tastic LEGO Party, up to 12 guests Number of Additional Guests LEGO Motor-Mania Party, up to 12 guests Number of Additional Guests $225 ea. $11 ea. $295 ea. $14 ea. Theme Choice: LOCATION Location Setup: Total No tax required 4
Birthday Party Credit Card Authorization Form I authorize NextGen SmartyPants, LLC to charge the credit card indicated in this authorization form in the amount indicated below on or after today s date indicated below. This payment authorization is for the goods and services selected in the Order Form, attached as reference, and for the amount indicated above only, and is authorized for one-time use only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated on this form. Further details associated with the below credit card are as follows: Account Type: Visa MasterCard AMEX PayPal Other Cardholder Name: Charge Amount: $ Card No. Expiration Date: Billing Address: City, State, Zip: 3 or 4-digit Code: Mobile Phone: Email: SIGNATURE Today s Date: Please return this completed form via fax or email, or just drop us a line: Call: (860) 272-4000 Fax: (860) 541-5830 Email: hello@nextgensmartypants.com 5