Field Trip Request Form

School/Group Name*

Number of Children*

Number of Classes*

Number of Chaperones*

Age Range*

Special Needs

The Museum's priority is to make educational programs accessible to all students. We ask that you please share any special needs your students may have ahead of time so that we can accommodate their needs and help offer appropriate programs.

Requested Date*

Requested Start Time*

:

Program Grade*

Select all that apply.

Type of Visit*

Exploration
Discovery

Topic/Theme*

Check each one you are interested in.

Would you like to eat your lunch at the Museum?*

Yes
No

Please be aware, this will affect pricing. There is an additional fee for a lunch space.

Contact Person*

Address*

Telephone (day)*

Email*

PROMO Code

Additional Questions/Concerns

Untitled

First Choice
Second Choice
Third Choice

Comments

This field is for validation purposes and should be left unchanged.

Museum hours:

Tuesday through Saturday

9:00am to 12:00pm

and

1:00pm to 4:00p

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The Children's Museum