Fields marked (*) are required
First Name*:
Last Name*:
Phone Number*:


Number of Children:

Ages (separated by comma):

Mailing Address




Zip Code:

A Few Questions
What kind of party have you hosted in your home in the past year?
Birthday or anniversary
Product-focused in-home event or party
Sports (e.g., Super Bowl)
TV (e.g., friends shared a favorite series, special show or movie)


If you've hosted a product-focused in-home event or party before:
How many (adult) guests attended?
How many children?
In what year(s) did you host this in-home event/or party(ies)?
If you were chosen to host a Child's Play Party! event, could you guarantee that 10 people would attend? Yes No
Which of the following have you done when staging an in-home event/party or social gathering of any kind? (Select all that apply)
Sent printed invitations
Emailed invitations to their email addresses
Invited guests using Evite or other party planning site
Made a song list or burned a CD for the event
Made or bought special decorations for the event reflecting a theme
Created activities (games, etc.) for guests to do
Taken photos at the event
Emailed photos/videos after the event or posted them on your blog, Facebook or Twitter
None of the Above
What else have you done to make your event(s) special?
What kind of refreshments do you serve your guests? (Select all that apply)
Soda and Soft Drinks
Bottled Water
None of the Above
What kind of food or snacks do you serve your guests? (Select all that apply)
Chips (potato chips, tortillas, pretzels)
Sweets (cookies, cake, ice cream, baked goods)
I prepare gourmet food
I like to serve healthy food
I order pizza or other take-out food
I cook out
I have my parties professionally catered
Pot luck where each guest contributes a dish
None of the Above
On average, how much do you spend hosting an in-home event or party?
If you were to host a party for 10 other moms, what would their age range most likely be?
Of that group of 10, how many children do they have combined?
What is their age range?
Are you currently:
Married/living with partner Single
Do you have children living at home? Yes No
Do you work outside the home? Yes No
If yes, full time or part time? Full Time Part Time
What do you do?
The highest level of education you have completed is? 
My annual household income is in the range of: 
I consider myself: 
The total number of people living in my household is 
The nearest big city to my home is:
Why I would make a GREAT Child's Play Party! host:
Are you active in social media?
Facebook Address (Please fill in if applicable)
Twitter Handle (Please fill in if applicable)
Blog URL (Please fill in if applicable)
Please read and agree to the Child's Play Party!
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