First and last name of birthday boy/girl *

We choose: *

French fries with frikandel or chicken nuggets at €9/person

Pancakes at €9/person

Date and time

When will you be celebrating your birthday? (Please submit your request at least 1 week in advance) *

What time would you like to be seated?

Miscellaneous

Do you have any special requirements or other comments?

Would you like to see a photo of the birthday boy or girl on our information screens? You can upload it here.

Organizer details

Last name *

First name *

Street name *

House number +box *

Postal code *

City/municipality *

Email address *

Phone number *

I agree that this form is binding. Changes can be reported up to 48 hours in advance at info@micocina.be AND at hasselt@sport.vlaanderen. *

Offers

Practical Information