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! School Group Admission Winston-Salem/Forsyth County School System Students: Free All other Forsyth County Students: $8 Preschool Students: $8 Out of County School Students: $10 Teachers: Free Bus Drivers: Free **Additional family members are welcome to visit the museum but will be required to pay full price and are not allowed into the group’s scheduled education programs or Digital Dome shows. Education Program Fees* (per person) PreK-12th Grade Programs: $7 Digital Dome Programs $7 Laser Shows: $4 WSFCS Title 1 schools receive one free program per group per year. *NC sales tax included on admission. Program fees are not taxed. 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 is held in LaSTEAM B (our cafeteria). Please be sure to reserve a lunch time when you schedule.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 $7 per visitor. View our Educator's Guide for more information about programs here. YesNoProgram 1 (Each program is $7 per visitor.)Shapes in Motion: A Geometric and Literature Adventure (Grades PreK-1)Shady Tales: Exploring Shadows, Light and Literature (Grades PreK-1)Sound Spectacular (Grades PreK-2)Creature Features: Fiction and Non-Fiction Fun (Grades PreK-2)Fur, Feathers, Scale and Slime (Grades K-2)Tiny Meteorologists (Grades PreK-1)What's the Matter (Grades K-2)Magnetic Marvels (Grades 1-2)Junior Meteorologists (Grades 2-4)Matter Mix-Up (Grades 3-5)Electricity and Magnetism Unleashed (Grades 4-6)Motion Commotion (Grades 6-8)Chemistry Chaos (Grades 6-8)Geology at Work (Grade K-6+) (Offsite)Number of StudentsProgram 2 (Each program is $7 per visitor.)Shapes in Motion: A Geometric and Literature Adventure (Grades PreK-1)Shady Tales: Exploring Shadows, Light and Literature (Grades PreK-1)Sound Spectacular (Grades PreK-2)Creature Features: Fiction and Non-Fiction Fun (Grades PreK-2)Fur, Feathers, Scale and Slime (Grades K-2)Tiny Meteorologists (Grades PreK-1)What's the Matter (Grades K-2)Magnetic Marvels (Grades 1-2)Junior Meteorologists (Grades 2-4)Matter Mix-Up (Grades 3-5)Electricity and Magnetism Unleashed (Grades 4-6)Motion Commotion (Grades 6-8)Chemistry Chaos (Grades 6-8)Geology at Work (Grade K-6+) (Offsite)Number of StudentsProgram 3 (Each program is $7 per visitor.)Shapes in Motion: A Geometric and Literature Adventure (Grades PreK-1)Shady Tales: Exploring Shadows, Light and Literature (Grades PreK-1)Sound Spectacular (Grades PreK-2)Creature Features: Fiction and Non-Fiction Fun (Grades PreK-2)Fur, Feathers, Scale and Slime (Grades K-2)Tiny Meteorologists (Grades PreK-1)What's the Matter (Grades K-2)Magnetic Marvels (Grades 1-2)Junior Meteorologists (Grades 2-4)Matter Mix-Up (Grades 3-5)Electricity and Magnetism Unleashed (Grades 4-6)Motion Commotion (Grades 6-8)Chemistry Chaos (Grades 6-8)Geology at Work (Grade K-6+) (Offsite)Number of StudentsDigital Dome Program 1 (Each program is $7 per visitor; Laser shows are $4.)Zula Patrol (Grades PreK-2)Hazelnuts (Grades PreK-3)One World, One Sky (Grades PreK-2)Earth, Moon, and Sun (Grade K-1)Cosmic Adventures (Grade K-5)Solar System Tour (Grade 1-6)Carolina Skies (Grade 3+)A Brief Mystery of Time (Grades 3+)Universe (Grade 3+)Oasis in Space (Grades 4-12)MicroCosm (Grade 5+)Expedition Reef (Grades 5+)All About the Cosmos (Grades 5+)Two Small Pieces of Glass (Grades 9-12)From Earth to the Universe (Grades 9+)The Great Space Chase (All Ages Laser Show)_$4Musical Laser Special (All Ages Laser Show)_$4Number of StudentsDigital Dome Program 2 (Each program is $7 per visitor; Laser shows are $4.)Zula Patrol (Grades PreK-2)Hazelnuts (Grades PreK-3)One World, One Sky (Grades PreK-2)Earth, Moon, and Sun (Grade K-1)Cosmic Adventures (Grade K-5)Solar System Tour (Grade 1-6)Carolina Skies (Grade 3+)A Brief Mystery of Time (Grades 3+)Universe (Grade 3+)Oasis in Space (Grades 4-12)MicroCosm (Grade 5+)Expedition Reef (Grades 5+)All About the Cosmos (Grades 5+)Two Small Pieces of Glass (Grades 9-12)From Earth to the Universe (Grades 9+)The Great Space Chase (All Ages Laser Show)_$4Musical Laser Special (All Ages Laser Show)_$4Number of StudentsDigital Dome Program 3 (Each program is $7 per visitor; Laser shows are $4.)Zula Patrol (Grades PreK-2)Hazelnuts (Grades PreK-3)One World, One Sky (Grades PreK-2)Earth, Moon, and Sun (Grade K-1)Cosmic Adventures (Grade K-5)Solar System Tour (Grade 1-6)Carolina Skies (Grade 3+)A Brief Mystery of Time (Grades 3+)Universe (Grade 3+)Oasis in Space (Grades 4-12)MicroCosm (Grade 5+)Expedition Reef (Grades 5+)All About the Cosmos (Grades 5+)Two Small Pieces of Glass (Grades 9-12)From Earth to the Universe (Grades 9+)The Great Space Chase (All Ages Laser Show)_$4Musical Laser Special (All Ages Laser Show)_$4Number of Students 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: