Register Your Kaleideum Field Trip Online! Fields marked with an * are required. Please complete the form below and submit your request to Kaleideum. The Kaleideum Museum Scheduling Coordinator will contact you to confirm your request. Reservations are not confirmed until you receive a confirmation email from Kaleideum. Thank you for choosing to spend your day at Kaleideum! For more information and descriptions of each field trip, please visit north.kaleideum.org and download the Kaleideum Educators' Guide under Field Trips. GROUP TYPE DESCRIPTIONS Winston-Salem/Forsyth County Schools Student and teacher admission is free. One chaperone per five students is admitted free ($7 per adult charge thereafter). Bus drivers are admitted free. Additional charges per person/per program apply. School Groups and Home School Groups outside Forsyth County $7 per student admission. Teacher admission is free. One chaperone per five students is admitted free ($7 per person charge thereafter). Bus drivers are admitted free. Additional charges per person/per program apply. School Groups (non WS/FCS) and Home School Groups within Forsyth County $5 per student admission. Teacher admission is free. One chaperone per five students is admitted free ($7 per person charge thereafter). Bus drivers admitted free. Additional charges per person/per program apply. Preschool or Child Care Group $5 per student admission. Teacher admission is free. One adult chaperone free per five children ($7 per person charge thereafter). Bus drivers admitted free. Additional charges per person/per program apply. Public Group Ages 11 months and under are free. $8 per person for youth ages 1-19, adults, and seniors. One chaperone per 5 students is admitted free. Bus drivers are admitted free. Additional charges per person/per program apply. School/Group Name*Name of Primary Contact* First Last Email of Primary Contact*Note: Due to some technical difficulties, if you operate within the gcsnc.com email system, please provide an alternate email address. School Phone Number*Primary Contact Phone NumberAddress*A bill will be sent to this address if invoice is unpaid at the time of the visit. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountyForsythDavidsonDavieGuilfordRockinghamStokesSurryYadkinGrade Level*Number of Visiting Students*Total Number of Visiting Classes*Number of Teachers*Please list the name of the Lead Teacher of each class*Separate names by a commaNumber of Parent Chaperones*Date Requested - First Choice* Date Requested - Second Choice Date Requested - Third Choice Arrival Time* : HH MM AM PM Departure Time* : HH MM AM PM Are you planning on having lunch at the Museum?*IMPORTANT! Lunch at Kaleideum North is held in FoodWorks. Space is first come, first serve and cannot be reserved. Please plan accordingly. YesNoUndecidedPlease choose your group type*Winston-Salem/Forsyth County Public School GroupSchool Group or Home School Group outside Forsyth CountySchool Group (non WS/FCS) or Home School Group within Forsyth CountyPreschool or Child Care CenterPublic GroupWill this group participate in a Kaleideum Program?*Each program is $6 per visitor. View our Educator's Guide for more information about programs here. YesNoProgram 1 (Each program is $6 per visitor.)Cantilever Challenge (Grade 4 – 8 +)Fur, Feather, Scale, Slime (Grade K- 5)Greedy Triangle (Grade Prek-K)Legos & Lights (Grade PreK)Magnificent Magnets (Grade 1-4)Marvelous Matter, Mixtures, & More (Grade K- 6)Robo Surprise! (Grade 4-8+)Science Extravaganza (Grade 3-6)Shocking Discoveries (Grade 3-7)Sounds All Around (Grade Prek-2)Weather Wonders( Grade K-2, 5)Geology at Work (GradeK-6+)Number of StudentsProgram 2 (Each program is $6 per visitor.)Cantilever Challenge (Grade 4 – 8 +)Fur, Feather, Scale, Slime (Grade K- 5)Greedy Triangle (Grade Prek-K)Legos & Lights (Grade PreK)Magnificent Magnets (Grade 1-4)Marvelous Matter, Mixtures, & More (Grade K- 6)Robo Surprise! (Grade 4-8+)Science Extravaganza (Grade 3-6)Shocking Discoveries (Grade 3-7)Sounds All Around (Grade Prek-2)Weather Wonders( Grade K-2, 5)Geology at Work (GradeK-6+)Number of StudentsProgram 3 (Each program is $6 per visitor.)Cantilever Challenge (Grade 4 – 8 +)Fur, Feather, Scale, Slime (Grade K- 5)Greedy Triangle (Grade Prek-K)Legos & Lights (Grade PreK)Magnificent Magnets (Grade 1-4)Marvelous Matter, Mixtures, & More (Grade K- 6)Robo Surprise! (Grade 4-8+)Science Extravaganza (Grade 3-6)Shocking Discoveries (Grade 3-7)Sounds All Around (Grade Prek-2)Weather Wonders( Grade K-2, 5)Geology at Work (GradeK-6+)Number of StudentsPlanetarium Program 1 (Each program is $6 per visitor.)All About the Cosmos (Grade 5+)Astro Moose Goes to Space (Grade K-3)Carolina Skies (Grade 3+)Earth, Moon, and Sun (Grade K-1)Follow the Drinking Gourd (Grade 1-5+)Solar System Tour (Grade 1- 6)Space in Motion (Grade 2-6)Space Voyagers (Grade 5+)Tour of the Seasons (Grade 2-6)Zula Patrol: Under the Weather (Grade PreK -2)The Great Space Chase (Lasers)Number of StudentsPlanetarium Program 2 (Each program is $6 per visitor.)All About the Cosmos (Grade 5+)Astro Moose Goes to Space (Grade K-3)Carolina Skies (Grade 3+)Earth, Moon & Sun (Grade K-1)Follow the Drinking Gourd (Grade 1-5+)Solar System Tour (Grade 1- 6)Space in Motion (Grade 2-6)Space Voyagers (Grade 5+)Tour of the Seasons (Grade 2-6)Zula Patrol: Under the Weather (Grade PreK -2)The Great Space Chase (Lasers)Number of StudentsPlanetarium Program 3 (Each program is $6 per visitor.)All About the Cosmos (Grade 5+)Astro Moose Goes to Space (Grade K-3)Carolina Skies (Grade 3+)Earth, Moon & Sun (Grade K-1)Follow the Drinking Gourd (Grade 1-5+)Solar System Tour (Grade 1- 6)Space in Motion (Grade 2-6)Space Voyagers (Grade 5+)Tour of the Seasons (Grade 2-6)Zula Patrol: Under the Weather (Grade PreK -2)The Great Space Chase (Lasers)Number of StudentsLaser Specials - $2 per personLaser FunSpace & BeyondSci-FiStars & StripesHalloween FunWinter Holiday Preview Please check this if your school is a Title 1 school Please check this if you are a Head Start Program Additional comments, questions, or concerns:Once you hit "Submit," you will receive an automatic email confirmation. If you have not received an automatic email confirmation from Kaleideum within 48 hours, please contact Christy Ferguson at (336) 714-7105. Important! Your field trip or group visit to Kaleideum North is not confirmed until you receive a confirmation letter from Christy Ferguson, the Kaleideum Museum Scheduling Coordinator. Please bring this confirmation letter with you to present to the front desk when you come. If you do not receive your letter within one week of booking your visit, please contact Christy via email or phone at (336) 714-7105.
