Empire Roller Rink Party Booking Form
Welcome to our online party booking. By filling this page out and submitting it to us via email, we can get in contact with you
within 24-48hrs about the availability of the dates you request and give you a total package price quote.  
PLEASE READ THE FOLLOWING POLICIES AND CHECK BELOW
Food Policy: Please do not bring outside food or drink to your party other than a cake, cupcakes or a brownie treat. Outside
soda, pizza, and ice cream are not allowed.
Clean Skate Policy: Your guests are welcome to bring their own skates, however they must be clean and in good repair.
Spectator Policy: Everyone between the ages of 3 and 18 must wear skates in the building at all times.
Adult guardians, parents, grandparents, and guests 18 & up can come in and watch. They do not have to pay admission or
wear skates.
Party Check In: We open the doors at the exact time your party is to start.  We know you may want to come in and decorate
however we are busy cleaning from the prior session.
EVERYONE MUST WEAR SKATES OUT ON THE WOODEN SKATING FLOOR--NO EXCEPTIONS.
Please fill out this form and we will get back to you to confirm the date and time of your party. Thanks
Party Times: Saturday 2-4, 7-9 , Sunday 1:30-3:30, Wednesday 12n-3pm, 6:30-8:30pm Thursday 12n-3pm
Groups of 50 or more available at other times.
Date & Time of Party
Birthday Child or Group Name
Parent name        
Phone Number
Home Address:
Email:
Child’s DOB
Child’s Age
Party Package:  
Main room @ $
Rain Forest Room @ $
Approx # of skaters:
If more than package number do we count collect?
Siblings  Count or  Collect?
Parents Count or Collect?
Add-Ons:  
Ice Cream platter $20.00
Glo Sticks $1.50 ea
Pizza’s $11.50 ea 1 toppings, how many
Pizza’s What Toppings?
How do you want to be
contacted, email or phone
any other? Other needs.
We will need a $50.00 deposit to hold the party, you can call with a credit
card 573-443-7375. The best time to call is Monday or Tuesday 11:30-1:30
pm Thanks you so much for booking your party with the Empire Roller Rink.