Fill out this form to register and an invoice will be sent to you by email.
Your Name:
Email Address:
Telephone:
Address:
Child's name:
Child's date of birth:
Child's name:
Child's date of birth:
Choose a class: Messy Mice
Baby Mice
Both
Choose a location: Southam
Leamington Spa
Payment Due [Includes £10 annual fee]: 1 child (10 weeks: 15 Sep - 28 Nov) £75
2 children (10 weeks) £120

Choose your payment method (instructions will be emailed to you): I will send a cheque/postal order
I will use paypal
How did you hear about Messy Mice?
If you do not get confirmation of your registration within 48 hours, please email us. If you have any other comments please note them here:

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Messy Mice is a company registered in England and Wales, number 6440389
All content Copyright © 2008 Messy Mice Ltd

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