Birthday Party Request

Birthday honoree's name *

Your name and relation to honoree *

Your address, city, state *

Phone number(s) *

E-mail address *

Please choose your preferred date and time, birthday party space is available on Saturday's. **Please note that all reservations are subject to availability *

Approximate number of guests *

How did you hear about birthday parties at Heart of the Valley? *

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, 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. * Signature/Date: