Field Trip Registration Form

Contact Information

Contact Name *

School or Organization *

Street address *

City *

State *

Zip code *

Phone number *

E-mail *

Name of Person Filling Out This form (if different from above)

Field Trip Preferences

Date (first choice) * +

Date (second choice) * +

Date (third choice) * +

Time *

Focused Field Trip Program Requested *

Yes

No

Name of Program *

20-Minute Lunch Room Requested *

Yes

No

(Reservations must be made in advance for lunch room)

Age/Grade of Children *

Special Needs: (physical/cognitive, etc.) *

Method of transportation to museum *

Trip Cost

	Number of Children ($5.00 per child)
	Required Adults, 1 adult for every 4 children (Free)
	Additional Adult ($5.00 each)
	ADD ON: Lunch Room Reservation ($20.00)
	ADD ON: Additional 30 Min. Play Time in Museum ($0.50 per child)
	ADD ON: Focused Field Trip Program ($1.00 per child)
	ADD ON: Focused Field Trip Program ($2.00 per child)

Current Total:

$0.00

Payment Method

To schedule your filed trip, a $50.00 non-refundable security deposit is required. This deposit will be directly applied to the total cost of your trip. Cash, school/organization check or credit cards are accepted. The remaining balance is due on the day of the field trip.

Please Note

- Completion of this registration form is NOT confirmation of a scheduled field trip. Your trip is confirmed when you receive a field trip contract and the deposit is paid.

- Field trip fees are applied to all attendees, including those with museum memberships

- We are a peanut-free facility, so please refrain from bringing peanuts and peanut products in lunches/snacks.

- Green Bay Area Public Schools and Head Start classes may qualify for reduced admission.

- If interested in the possibility of scheduling a field trip before or after regular hours of operation, please contact the museum for more information.

- For further information or questions, please contact Whitney at 920-432-4397 or wpotvin@gbchildrensmuseum.org

9:30am-11:30am	10:00am-12:00pm
10:30am-12:30pm	11:00am-1:00pm
11:30am-1:30pm	12:00pm-2:00pm
Other: Other: