Kick & Play Private Group Request

Interested in having a private group with Mimi, Pepe and the rest of us at Kick & Play? Please fill out the form below, and we will call you as soon as possible to answer any and all questions you may have. Thank you for thinking of us, and we hope to make this the best Private Group ever!


Organizer's Name:
Primary Phone #: () -
Email:
Start Date:
End Date:
Time(s) Requested:
Anticipated # of Children:
Age Group:
Location: Upper East Side
Upper West Side
Downtown
Brooklyn
Bronx
Hoboken
Jersey City
Westchester
Queens
Hamptons
Other
Have you participated in
a Private Group with us before?

           Yes                            No

If "Yes" please provide details below:


Special Requests/Notes: