Special Workshop Registration

Please register for the number of individuals using their own set of materials. A child with an accompaning adult might only use one set, unless the adult wants to do the activity themselves, too.

All participants under 16 need an accompaning adult. One adult can work with multiple kids.

Participant's Name*

*

Last Name

Grade Level*

Age*

Participant's Name 2

Last Name

Grade Level

Age

Participant's Name 3

Last Name

Grade Level

Age

Are you members of the MESS Hall?*

YesNo

Which program would you like to attend?

Robotics April 11

Which time? Please indicate the number of individual set of materials you will need (parents can team with kids, older kids with younger, etc)*

If all workshop slots are filled for your desired time, there is a possibility that there will be space due to no-shows. Additionally, we will have numerous other special activities to try.

These workshops are included with admission. Admission is $15 per person ages 3 and up, including adults. No child is admitted without an adult over 18.

Have you attended a program at the MESS Hall before?*

YesNo

What school does your child (if any) attend? (Optional)

Is anyone in your household active duty military? (Optional)

YesNo

Parent/Guardian Information

Name*

*

Last Name

Main Number*

Format: (000) 000-0000.

Address*

Street

City*

State*

Zip Code*

E-mail*

Informed Consent and Acknowledgement

In consideration of participation by myself and my child 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 participation by myself and my child 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 participation by myself and my child.

I give permission for photos and/or likenesses of myself and my child to be retained and used by Pensacola MESS Hall without any remuneration or compensation.

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.