Name *

First Name

Last Name

Phone *

(###)

###

####

What Date would you like to celebrate at The Beacon? *

MM

DD

YYYY

Are you interested in one or both of our birthday activities? *

45 min Breaking Lesson

45 min Mini Graffiti Lesson

Are you interested in renting our Play Space? (For kids 5 years under) *

Our play space includes: ball pit (with balls), tunnel, foam stairs, blocks, gates, multi-color floor mats

yes

no