Schedule Appointment with Over The Moon Play Space

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First Name *

Last Name *

Phone *

Your E-Mail Address *

Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
Over The Moon $10 Gift Certificate		$10.00
Total: $10.00	Coupon:

I understand and agree that:

For Gift Certificate purchases
- They are non-refundable
For Membership purchases:
- I have read and agree to all policies on the memberships page, including but not limited to:
- Memberships may be used for up to one Open Play or Lunch Bunch each day.
- My credit card will automatically be charged once per month (starting 30 days from now);
- There are no refunds once charged;
- I can cancel anytime and use the remainder of the month that has been paid for;
- They are NOT recommended primarily for weekend use, as availability is extremely limited;
- I may cancel appointments until 2 hours in advance. I authorize "No Show" appointments to be charged at the regular Open Play rate. (If you or your child is sick, please call us and we will, of course, waive the no-show fee)