KCSC Road Trippers Registration Form

KCSC Road Trippers' Registration Form

Please fill out the below form to register for our upcoming road trip! This program is for older adults who want to go places with likeminded and similarly aged people. The KCSC Road Trippers' will offer regional day trip travel experiences designed with lifelong learners in mind — those who want to learn about our destinations and experience new adventures in a group setting.
Wednesday, May 14, 2025
The History of Leavenworth Day Trip

Take a day trip back in time to the historic city of Leavenworth, Kansas. Discover fascinating stories, iconic landmarks, and the rich history that makes this city a cornerstone of the Midwest. Don’t forget your walking shoes and your curiosity—this trip is sure to enlighten and inspire!

Seating is limited. Registration deadline is May 1, 2025.

The cost per person for this trip is $40. You can pay online. You will be redirected to the online donation page after you complete this form.

**Please put in the NOTES section: ROAD TRIPPERS.

OR you can write a check and mail it to our offices at the address below.

**Please put ROAD TRIP in the memo line.

We will meet at the KC Shepherds Center offices: 9200 Ward Parkway, KCMO 64114. Parking is free.
The History of Leavenworth Day Trip

May 14, 2025
Name of Attendee (Please fill out a form for each attendee separately):*

First NameLast Name
Are You Attending Alone or With Someone?
If Attending With Someone, Please Provide Their Name Here:
Phone Number*
Please enter a valid phone number.
Phone Type*

CellHomeWork
Email:
example@example.com
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Person:*

First NameLast Name
Emergency Contact Phone Number:*
Please enter a valid phone number.
Please describe any medical concerns, disabilities or dietary choices (gluten, allergies, vegan) that you wish to share or questions about the food options:
Thank you for registering! Please leave any comments or questions you may have below.
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KCSC Road Trippers' Registration Form

The History of Leavenworth Day Trip