A $(k \times l)$-birthday repetition $\mathcal{G}^{k \times l}$ of a two-prover game $\mathcal{G}$ is a game in which the two provers are sent random sets of questions from $\mathcal{G}$ of sizes $k$ and $l$ respectively. These two sets are sampled independently uniformly among all sets of questions of those particular sizes... We prove the following birthday repetition theorem: when $\mathcal{G}$ satisfies some mild conditions, $val(\mathcal{G}^{k \times l})$ decreases exponentially in $\Omega(kl/n)$ where $n$ is the total number of questions. Our result positively resolves an open question posted by Aaronson, Impagliazzo and Moshkovitz (CCC 2014). As an application of our birthday repetition theorem, we obtain new fine-grained hardness of approximation results for dense CSPs. Specifically, we establish a tight trade-off between running time and approximation ratio for dense CSPs by showing conditional lower bounds, integrality gaps and approximation algorithms. In particular, for any sufficiently large $i$ and for every $k \geq 2$, we show the following results: - We exhibit an $O(q^{1/i})$-approximation algorithm for dense Max $k$-CSPs with alphabet size $q$ via $O_k(i)$-level of Sherali-Adams relaxation. - Through our birthday repetition theorem, we obtain an integrality gap of $q^{1/i}$ for $\tilde\Omega_k(i)$-level Lasserre relaxation for fully-dense Max $k$-CSP. - Assuming that there is a constant $\epsilon > 0$ such that Max 3SAT cannot be approximated to within $(1-\epsilon)$ of the optimal in sub-exponential time, our birthday repetition theorem implies that any algorithm that approximates fully-dense Max $k$-CSP to within a $q^{1/i}$ factor takes $(nq)^{\tilde \Omega_k(i)}$ time, almost tightly matching the algorithmic result based on Sherali-Adams relaxation. (read more)