School Field Trip Form

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 Number

Address*

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

County

Grade 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 comma

Number of Parent Chaperones*

Date Requested - First Choice*

Date Requested - Second Choice

Date Requested - Third Choice

Arrival Time*

Departure Time*

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.

Yes

Undecided

Please choose your group type*

Will this group participate in a Kaleideum Program?*

Each program is $7 per visitor. View our Educator's Guide for more information about programs here.

Yes

Program 1 (Each program is $7 per visitor.)

Program 2 (Each program is $7 per visitor.)

Program 3 (Each program is $7 per visitor.)

Digital Dome Program 1 (Each program is $7 per visitor; Laser shows are $4.)

Digital Dome Program 2 (Each program is $7 per visitor; Laser shows are $4.)

Digital Dome Program 3 (Each program is $7 per visitor; Laser shows are $4.)

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:

Name

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

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