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									                                                                                                         The gift
As the person in charge of scheduling and ar-
ranging this party, I accept full responsibility for

                                                                                                            of fun
all persons listed on this roster and release and
discharge Sanford USD Medical Center, Sanford
Wellness Center, and its employees from any
damages, actions, or whatsoever to persons listed
in connection with the use of services, facility, and
premises of the Wellness Center.
Signature ________________________________
Date ____________________________________
We looking forward to helping you make your
child’s milestone a memorable one. We would
appreciate it if you could take a minute to read
and complete this roster.
Responsible party _________________________
Phone Number ___________________________
Birthday Child’s Name ____________________
Age _____________________________________
Date of Party_____________________________                                                               Birthday bash
Time of Party ____________________________
                                                                                                         You’re looking to celebrate.
Please list names & ages of guests attending party:
                                                                                                         Your “baby” is another year
Name                                      Age
                                                                                                         older. You want it to be fun.
1. _______________________________________
                                                                                                         But you also want it to be
                                                                                                         safe. Let Sanford Wellness
                                                                              Sanford Wellness Center
                                                                                                         Center help.
                                                                                        4201 S. Oxbow
5._______________________________________                                        Sioux Falls, SD 57106
(Please read and complete back of form)
*2 weeks in advance                                     200-12900-0035 2/11
Pool party                                                Private pool party                                          Walleyball party
Enjoy one hour making a splash with friends in            Wouldn’t it be great to have a pool all to yourself ?       Take a whack at walleyball. We’ll set up the net
our main pool, followed by one hour in Simon’s            You can. Party includes one hour in the warm water          just for your group. Party includes one hour of
Care for gift opening and treats. We provide              pool (life guard provided), followed by one hour in         play, followed by one hour in Simon’s Café for
special pool toys especially for your group.              Simon’s Café for gift opening and treats.                   gift opening and treats.
(Designed for birthday child and 9 guests.                (Available times are Saturdays & Sunday’s 1-3p.m.           (Designed for birthday child and 9 guests.
Please schedule at least one week prior to party.)        Designed for birthday child and 9 guests.)                  Please schedule at least one week prior to party.)
Member: $50                                               Member: $80                                                 Member: $50
Non-member: $70                                           Non-member: $100                                            Non-member: $70
(extra guests $3.50 each)                                 (extra guests $3.50 each)                                   (extra guests $3.50 each)

Let us provide the party treats!
Take a break from the kitchen. Simon’s Coffee Shop & Café can bake a half sheet cake w/ personal decorating
for $25 or a giant-sized chocolate chip cookie for $20.
(We also provide plates, forks, cups and napkins)

                                                          Things to know
                                                            • The Wellness Center will provide towels for those who choose to have a pool party. We will also provide
                                                              plates, cups, forks, napkins, cake or giant cookie if you choose to add party treats to your package.
                                                              You will need to bring a beverage to drink and candles for the cake.
                                                            • We ask you pay on the day of the party.
                                                            • Guests and responsible party are also asked to check in with the lifeguard on duty before getting into the
                                                              water for those having a pool party. For children age 7 and under, the parent MUST remain in the pool
                                                              area at all times while the children are swimming. For children over age 7, the parent does not need to be
                                                              in the pool area, but MUST remain in the Wellness Center. We ask that an adult of the same sex as the
                                                              party guests accompany the kids while in the locker room.
                                                            • Clean up after the party is your responsibility. To help you out, we will provide supplies. Please pick up
                                                              any garbage and put tables and chairs back in place.
                                                            • If you would like to photograph or videotape the party, please see front desk staff for
                                                              camera authorization.
                                                            • To schedule your party, please call Tami at (605) 328-1635.

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