Baker's Dozen Academy LLC

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Birthday Party Package - Registration form

Date: _____________

Time: _____________


Location: __________________________________________________________


Birthday Customized Dessert Option 1: ___________________________________


Details of Dessert selection: ____________________________________________


Birthday Customized Dessert Option 2: ___________________________________


Details of Dessert selection: ____________________________________________


Name of Guest of honor: ______________________________________________


Number of birthday guests: (minimum of 10 guests)___________________________


Personal information: Address: __________________________________________


Phone Number (s): _______________________   Email__________________________________


Emergency contact number: ________________________________________


Are there any medical conditions that we should be aware of? _______________________________


Receipt of your payment constitutes agreement to the terms of the registration and waiver form.


Total amount due: $_______________


Deposit of $100.00 required (non-refundable)  Check# ______________  Date _______________

Amount due at party: $___________________

Please notify Baker's Dozen Academy of number of guests 1 week prior to event.

If paying by check, make check payable to: Baker's Dozen Academy and mail in with this form

Mail this form to:

Baker's Dozen Academy

715 North Gross St.

Conway, PA 15027

Any questions? E-MAIL us at: or call us: Deb (724) 272-6242 or  Teri (412) 671-3396