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Participant Information

Participant's Name

First NameLast Name

Date of Birth

Date

Thank you for your interest in our programs. To ensure that our programs meet the needs of all participants, we require students to be 3 by September 1. Because of the hands-on nature of the activities, this cutoff is a rough approximation of the fine-motor skills of the participants.

Please visit the MESS Hall with your student during regular hours to explore our activities. We look forward to seeing you at a program in the future.

Are you members of the MESS Hall?

Entered Email

If you believe you have an active membership but it is not showing up, please continue with the form. Contact us and we can check any issues and refund the member difference.

Last Renew Date

First Name - Member

First Name

Last Name - Member

Last Name

Address - Member

Street Address

City - Member

City

State - Member

State

Zip - Member

Zip Code

Thank you for entering your email address and for supporting the MESS Hall with your membership. For reference, the following is the information we have on file for you. If anything needs to be updated, please reply to the confirmation email with needed changes.

{firstName} {lastName214}

{address215}

{city216}, {state217} {zip218}

{phonelu}

Consider becoming a member, which provides free admission to the MESS Hall during regular hours. Keep learning and discovering with your students beyond the field trip!

Programs

Have you attended a program at the MESS Hall before?

September

October

November

December

January

February

March

April

Member

Cost of programs

Coupon Code

Onsite

Total

Interaction

Parent/Guardian Information

First Name

Last Name

Family Name

PhoneLU

Format: (000) 000-0000.

Phone Number

Format: (000) 000-0000.

Address

Street Address

City

State

Zip Code

E-mail

example@example.com

Date

Email for confirmation

The expectations, rules, and procedures of the Pensacola MESS Hall are intended to keep the classroom environment safe, organized, creative, and productive. Because of the tool use, we need caregivers to help ensure that the environment is a safe one. Therefore, we ask for no more than 2 kids per caregiver and that there are no "tagalongs".

Please note that this program will be in a classroom space. There will be no access to the regular exhibits before, during, or after the program, though your child will see them upon arrival.

Informed Consent and Acknowledgement

In consideration of my child’s participation in programs provided by the Pensacola MESS Hall, I indemnify and hold Pensacola MESS Hall and its affiliates, employees and agents harmless from and against any and all liability for negligence or medical expenses resulting from my child’s participation in such programs or other activities. I further release Pensacola MESS Hall and its affiliates, employees and agents from any and all negligence or other claims resulting from my child’s participation. I further understand that Pensacola MESS Hall does not provide medical insurance coverage for my child and that any medical expenses incurred will be paid by either my own medical insurance or myself. I hereby grant permission for my child to participate in all activities.

I give permission for my child’s photo and/or likeness to be retained and used by Pensacola MESS Hall without any remuneration or compensation.

Cancellation Policy & Tuition Refund

Cancellations made 48 hours or more in advance of the event date will incur a $5 administrative fee. Cancellations made within 48 hours of the event will incur a 50% administrative fee. There will be no refunds offered for missed classes without notice once class has occurred.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Total Cost

USD

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.