Person Making the Reservation:*

Name of School:*

School Mailing Address (please include city and zipcode):*

School Phone Number:*

Contact Phone Number:*

Contact E-mail Address:*

Lead Teacher for the trip (this person should be attending the day of the trip):*

Cell phone number of Lead Teacher (used only for emergencies):*

Does your school receive Title 1 funding?*

Number of students attending the 4th grade Healthy Minds, Healthy Bodies field trip.*

Number of chaperones (any adult including teachers, parents, legal guardians, grandparents or siblings 18 and older). A ratio of one chaperone per every 10 students is required.*

Does your group have any accessibility needs or require any special accommodations that are not listed above or require further explanation? Please let us know so we can better plan your visit.

Please list below, in order of preference, the date your group would like to visit Frost Science (Monday - Thursdays only).

Date 1*

Date 2*

Date 3*

Would you like to add a planetarium show to your Healthy Minds, Healthy Bodies Field Trip ($5.00 per person)*

Please choose from one of the following lunch options for your students; lunch rates are only valid for groups that reserve their lunches in advance. Lunch orders cannot be modified or canceled within 5 business days prior to your visit. Frost Science is NOT a nut-free institution, though we offer nut-free meals. We ask all program participants to respect the food restrictions of fellow classmates and guests, but it is not a nut-free facility.

Will your group be visiting the gift shop during the fieldtrip?

Lunch*

Ham and cheese sandwich and bottle of water ($8.00 + 8% sales tax). Please list quantity required below:

Turkey and cheese sandwich and bottle of water ($8.00 + 8% sales tax). Please list quantity required below:

Veggie sandwich [eggplant, portobello, squash, cheddar and hummus spread] and bottle of water ($8.00 + 8% sales tax). Please list quantity required below:

By submitting this reservation, you are requesting a field trip to Frost Science. If the date requested is available, an invoice will be emailed to the contact person submitting this form within 5 business days. Please note, that a 25% deposit is required to hold your field trip date. School group rates apply to groups with at least 10 students (pre-K to college). Special needs groups are not required to have the minimum 10 students.

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