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Goldenrod Farm Summer Birthday Party Reservation Form

Adult name: ______________________________________
Address: _________________________________________
City: ____________________State:________Zip:________


Child's name:______________________________________
Number of candles:______________
Cake flavor (circle one).... White Chocolate
Frosting flavor (circle one) White Chocolate

Date and Time Requested:___________________________
Home & work phone:_______________________________
No. of Children (max 12):____________________________
No. of Adults (2 free):_______________________________

Basic Party $5. per child, Min $55...._____________
Pony rides $20. per party, ................._____________
Giggles the Clown, $25. per party....._____________

Subtotal: ............................................ _____________
Deposit:.............................................. ____25.00____
Balance Due on Day of Party:............_____________

Signature:_________________________________________

Please print this form and send with a check or money order for the amount of your deposit to:

Goldenrod Animal Farm
HCR 65 Box 38A
Sherman Station, ME 04777

Phone:207-365-4845
e-mail address.

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