Membership Application

To purchase a membership as a gift, please click here.

Membership

"*" indicates required fields

Type of Purchase:*

Type of Membership*

Please select your desired membership level.

Number of Adults on Membership:*

How many adults from the same household would you like to include on your membership?

Do you have any add-ons?*

Add-ons are additional people you would like to add to your membership (e.g., a babysitter) for a cost of $50 per person.

Primary Named Adult

Name*

First Last

Birthday*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Email*

Newsletter

Yes, I'd like to receive Buckeye Imaination Museum's newsletter

Second Named Adult

Name

First Last

Birthday

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone

Children's Information

Children 16-18 on the Membership*

Please list the first and last name of all the children age 16-18 from the same household with a state-issued ID or driver's license. Each child listed here will receive their own membership card, along with the same membership permissions as primary-named adults.

Children on the Membership*

Please list the first and last name of all the children under 16 who live in the household of the applying member. For the Grandparent Membership: List the full names of all your grandchildren under age 18.

Add-ons

Add up to two additional named adults (i.e., babysitter) to your qualifying membership for $50.00 each. Add-ons must be at least 16 years of age. No more than two Add-Ons permitted per membership. Additional named adults, “Add-Ons,” can visit independently from the primary-named adult members. Add-Ons will receive their own membership card. Add-ons are required to show their membership card and valid photo ID to gain admission to Buckeye Imagination Museum.

How many add-ons?*

Limit 2

First Add-On*

First Last

Birthday

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Second Add-On*

First Last

Birthday

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Membership Conditions

Members are required to show their membership card, along with a valid photo ID, each time they visit the museum in order to gain admission.
Children must be supervised at all times, and adults must be present. Buckeye Imagination Museum requires at least 1 adult for every 5 children.
Guests will be charged for replacement of any items damaged. If guests do not treat exhibits or staff with respect, they will be asked to leave.
Buckeye Imagination Museum reserves the right to revoke any membership without notice.
Memberships, membership ad-ons, and reciprocal stamps are non-refundable.
By signing this contract, you are agreeing to abide byBuckeye Imagination Museum's Rules of Play. For a copy of this policy, see the front desk.
By signing this contract, you are agreeing to the Buckeye Imagination Museum Media Release Policy, which states that Buckeye Imagination Museum reserves the right to use any photos and videos taken on Buckeye Imagination Museum property of any and all members associated with this membership and you waive all rights to those media. For the full policy, see the front desk.
Buckeye Imagination Museum believes in the safety of its guests and staff at all times and, therefore, will follow the Buckeye Imagination Museum Inclement Weather Policy and the Buckeye Imagination Museum Sick Guest Policy. For a copy of these policies, please see the front desk.

*PLAY AT YOUR OWN RISK*

Agreement*

I have read and agree to the membership conditions above and attest that all the information provided is accurate and truthful.

I agree

Payment

Total

Credit Card*

Cardholder Name

Card Details

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Contact Info

175 W Third Street
Mansfield, Ohio 44902

Phone: 419-522-2332

info@buckeyeimaginationmuseum.org

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Membership Application

Membership

Primary Named Adult

Second Named Adult

Children's Information

Add-ons

Membership Conditions

Payment

Buckeye Imagination Museum recognizes the importance of transparency related to our non-profit mission to provide children and families opportunities to learn and discover through the power of play. With that in mind, we are a proud partner of the Guidestar Exchange Partners in Trust program.

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