If you are human, leave this field blank. ALL ABOUT THE BIRTHDAY GIRL/BOY! Birthday honoree's name * Checkboxes Boy Girl How old is he/she turning? Youth t-shirt size * Small Medium Large XL Your name and relation to honoree * Your address, city, state Phone number(s) E-mail address PARTY DETAILS! Please choose your preferred date and time, birthday party space is available on Saturdays and Sundays **Please note that all reservations are subject to availability * Time: * 12pm-3pm 1pm-4pm Approximate number of guests HOV will provide the supplies for any two of the following activities (choose 2) Make Cat Toys Design Pet I.D. Tags Decorate Pet Bandanas Make Dog Biscuits (may include peanut butter, please mention any allergies) Make Dog Toys How did you hear about birthday parties at Heart of the Valley? COST & PAYMENT METHOD Birthday party facility rental fee: $130.00 I would like to pay with cash I would like to pay with check (checks payable to Heart of the Valley) I would like to pay with credit/debit card At this time I would like to pay: $50 Deposit $130 Total Party Cost Would you like to include an "adoptable" plush animal to be presented to your child at their party? (Additional $10 fee paid at time of deposit) Bosco the Chocolate Labradoodle. Dilly the Dachshund Abraham the Black Lab Hally the Orange Striped Cat Snippy the Black and White Cat Credit/debit card # 3-digit security code on back Expiration date Name on card Terms of Agreement and Liability Release I understand that, for a fee of $130.00, Heart of the Valley will provide use of the Community Room and adjacent restrooms and kitchen, including the use of tables and chairs for a period of 3 hours as selected above. In addition, Heart of the Valley staff or volunteers will provide a shelter tour, the opportunity to meet shelter pets, the supplies for up to 2 activities as selected above, a birthday t-shirt, and the special birthday honor of naming an incoming stray shelter pet. I understand that Heart of the Valley will not provide any food, drinks, transportation, or gifts. I understand that smoking is not allowed in the Community Room. I give permission for Heart of the Valley to use photos or video of myself or any participating children and guests in Heart of the Valley sponsored activities for promotional or educational purposes. I am responsible for ensuring that 1 adult chaperone for every 4 party guests is present at all times while guests are present at the shelter. I agree to assist in returning the Community Room to a clean and orderly condition at the end of the birthday party, and to pay the cost for repair of any damages to the facilities. Heart of the Valley is not responsible for any materials or equipment left in the building. If the room is not left in satisfactory condition, a minimum charge of $130.00 will be levied. I will notify Heart of the Valley as soon as possible if I need to cancel the birthday party so that the room can be made available for others. To the extent permitted by law, I agree to protect, indemnify, defend and hold harmless Heart of the Valley, Inc., and it’s respective employees and agents against all claims, losses or damages to persons or property, governmental charges or fines, and costs (including reasonable attorney's fees), arising out of or connected with my function, except those claims arising out of the sole negligence or willful misconduct of Heart of the Valley, Inc. In consideration of this agreement to rent the Community Room, I hereby for myself, my administrators, my heirs, and assigns, waive and release any and all right and claims for damages I have against Heart of the Valley, Inc., their associates and representatives. I also agree to exercise all safety precautions and respect the property of Heart of the Valley, Inc. Thank you for including Heart of the Valley in your celebration! Many birthday honorees ask their guests to bring donations for the shelter in lieu of gifts. Heart of the Valley is very grateful for this generosity and will gladly accept all donations. For a list of some of the items needed at the shelter, you can view our ‘WISH LIST’ online under the ‘WAYS TO GIVE’ and then ‘EVEN MORE WAYS’ tab. You can also call 388-9399. Questions or comments?