Win Free Kid's Birthday Party Event valued at $150.00

The Promotion takes place OCT 15th (Saturday) through OCT 31st (Monday). OPEN TO YOUTHS.

Terms & Conditions:

  • Complete this form submission to enter for chance to win a Kid's Birthday party (up to 8 kids).
  • Winner to be selected November 2, 2016.  Event must be booked/confirmed by November 23, 2016.
  • Shall not be combined with any other promotion, coupon, offer, or discounted rate
  • Shall not be used with Leagues, Tournaments or other Events (i.e. youth or daycare outings/camps, private parties, business or club outings, etc.).

PLEASE COMPLETE THE FORM BELOW TO REGISTER.

Coupon # located on Park Place Lanes Hershey Milk Chocolate Bar.
Adult Contact Information
All coupon notifications are sent via email to the parent or guardian on file. Please enter a valid email address otherwise notifications cannot be delivered.
Name *
Name
Mobile Phone *
Mobile Phone
Mailing Address: *
Mailing Address:
Child Registration
Please enter the names of the children that you would like to have participate in this program. If your children are older than the age restriction please do not sign them up.
Age Requirement: Ages 15 and under
Child Name
Child Name
Child Name
Child Name
Child Name
Child Name
Child Name
Child Name
Child Name
Child Name
Authorization and Acknowledgements
READ THIS SECTION, PLEASE.
By clicking accept: *
I certify I am the parent/guardian of the children named in this registration, and they all live in my household. I affirm that I am at least 21 years of age and the information I have provided in this entry form is true to the best of my knowledge, and I have not knowingly withheld any information requested. I understand that withholding or misstating any information requested in this entry form is grounds for rejection of my entry and disqualification from participation. I authorize the company to verify my information I have provided. In addition, I release the company, and all other persons and entities, from any and all claims, demands or liabilities arising out of or in any way related to this entry and the promotion offer. Express Permission: I would like to receive marketing email from Park Place Lanes.