BIRTHDAY PARTY RESERVATION FORM
Geyser Falls must receive your completed birthday order form and full payment FIVE (5) days prior to your party. You
may mail or fax your order form to Geyser Falls with a credit or debit card, cashier’s check or money order. Please allow
up to two (2) business days for a confirmation phone call. Each package includes a reserved area in the Birthday area for
your hour party time, burgers/hotdogs, 12oz can drinks and desserts.
Packages include: 1 - Free Admission for Birthday Child, Discounted admission for the remaining people in
the package, 1 - Free logo drawstring backpack, 1 - Free towel, Burger or hotdog meal,
Dessert & drink for each person.
Package A: $99.00
Package B: $249.00
10 guests, 1-reserved table, 10 hotdogs or hamburgers,
10 can drinks and 10 desserts
25 guests, 2-reserved tables, 25 hotdogs or hamburgers,
25 can drinks and 25 desserts
Party Date: ______________________________________________
Party Time: (Circle First Choice)
Food: (List How Many of Each)
Drinks: (List How Many of Each)
11:00am to 12:00pm
__ Hotdogs
__ Hawaiian Punch
12:30pm to 1:30pm
__ Hamburgers
__ Sierra Mist
2:00pm to 3:00pm
3:30pm to 4:30pm
Contact Name: _____________________________________Child’s Name: ________________________________________
Address: _________________________________________City: _________________________ State: _____ Zip: _________
Day Phone: _______________________ Night Phone: ____________________ Email: _______________________________
Package _____
$_____________
Add 7% Sales Tax
Grand Total
$_____________
$_____________
(packages do NOT include park admission)
Payment Method: (Check One)
Cashier’s Check (no personal checks!)
Money Order
Credit Card
Master Card
Visa
Discover
American Express
Credit Card Number: _________________________________Exp.Date: __________
Name as Shown on Credit Card: __________________________________________
Signature: ________________________________________ Date: ______________
*Prices and dates subject to change without notice.
This does not constitute a valid offer.
Purchaser’s Agreement: Please read and sign below
Disclaimer: Tickets are the property of Geyser Falls Water Theme Park at Pearl River Resort. Hours and dates of operation are subject to change without notice. Tickets are
valid any operating day unless noted otherwise on the ticket. As the Birthday Party purchaser I understand it is my responsibility to ensure my group is aware of all park rules
and regulations. Rules are posted at the park entrance and on safety signs throughout the park. A copy of the park Code of Conduct is available by request from our office or
online at www.GeyserFalls.com. For guest safety, Geyser Falls strongly recommends and I understand that if I have any attendees between the ages of 12 -18
years of age, a responsible chaperone should be provided at a ratio of at least 1 chaperone per 15 youth. Additionally, Geyser Falls strongly recommends
and I understand that for participants under the age of 12, constant adult supervision is required by a responsible adult at a ratio of at least 1 chaperone
per 5 children. My failure to abide by these terms may result in the exclusion of both myself and my children/youth participant from Geyser Falls without a
refund of purchase price. I understand that, ultimately, my child’s / youth participant’s safety and supervision is my responsibility.
Purchaser’s Signature: ______________________________________________________________ Date: _______________________________
Mail to: Attn: Group Sales Geyser Falls Water Theme Park, P.O. Box 6046, Choctaw, MS 39350
Fax to: Geyser Falls Water Theme Park, (601) 389-5501
Revised Apr. 2017