Name Of Contact Person
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First Name
Last Name
Email
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Phone
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(###)
###
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Are You A Subscribed Member
NO
YES SPECTATOR PLAN
YES CHALLENGER PLAN
YES CHAMPION PLAN
Member Name
How Did You Hear About Us
Yelp
Google
Social media
Word of mouth
Nextdoor
Name of Person(s)/Team Or Group We Are Celebrating. (Ex, Birthday Person, Name Of Graduate, Name Of School Event, Name Of Community Event) *
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What Is The Celebration/Occasion? (Ex. Birthday, Graduation, Sporting Event, Church Event, School Event, etc.) *
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Are There Any Specific Themes? (Ex. Colors, Characters, Sportswear, Favorite Game, etc.) *
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Age Of Person(s) We Are Celebrating (ex. How Old Will The Birthday Boy/Girl Turn?) *
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Average Age Of Participants *
*
Expected Number Of Attendees *
*
Please Choose Your Top 3 Video Game Preferences (Ex: Fortnite, NBA 2K, Madden, Roblox, UFC4, GTA, etc.) *
Are There Any Prohibited Video Game (Ex: No Mortal Kombat, No GTA, No Shooting Games, etc.)? Please List Restricted Games Or Write “None”
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Desired Date of Booking *
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MM
DD
YYYY
Secondary Date Choice If First Is Not Available? *
MM
DD
YYYY
Desired Start Time (Must be 2 hour minimum) *
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Desired End Time *
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Is Your Desired Time Flexible*
Yes
No
Address Of Event *
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Is the Address Provided a “Dead-End” Road *
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YES
NO
Please Select Any Additional Services/Activities (Additional Fees Will Apply). Please Select All Services You Wish To Be Added To Your Package & We Will Provide The Price Via Text/Email.
*
Virtual Reality
Gamer Headphones
Decorations
Cake/Cupcakes/Cakepops
Caterer
Stone Bake Pizza
Hotdogs
Mobile Beverage Bar
Customized Invitations
360 Photo Booth
Tables/Chairs
No Additional Services Required
I Understand That full Payment Is Due Prior To The Start Of the Booking. No Refunds Will Be Issued For Last Minute Cancelations.
*
YES
I Understand That KAYGE Gaming Is Not Responsible For The Speed Or Quality of the Internet Connection in Your Area. An Unsatisfactory Internet Connection May Effect Some Video Games. No Refunds / Discounts will Be Issued For Poor Internet Connection.
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YES
PLEASE NOTE: Adult Supervision Is REQUIRED For Guests Requiring “Special Considerations” (e.g., Children Under The Age Of 7, Physical Limitations/Impairments, Use Of Assistive Devices, Neurodevelopmental Disorders, Epilepsy, etc.)
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YES I ACKNOWLEDGE
I Attest And Acknowledge My Understanding Of The Rate Of $200/Hour Applies To All Bookings Scheduled For 3 Or More Hours. Additionally, I Acknowledged Understanding That A Minimum Of 2 Hours Is Required For All Bookings. 2-Hour Bookings Are Billed At $250/Hour.
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YES
All Credit/Debit Card Payments Will Incur a 4% Processing Fee And Must Be PAID IN FULL No Later Than 3 Days Prior To Your Booking Date. To Avoid Fees, We Recommend You Use Other Payment Options Provided On Our Payment/Donation Page.
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I UNDERSTAND
Name Of Person Completing This Form
*