Summer Field Trip and Outreach Form 2019

We look forward to enhancing your summer program with science. In order to most efficiently schedule your group, we would appreciate your replies to the following questions.

Organization Name *

Address *

Street Address
Street Address Line 2
City	State
Zip Code	Country

Contact Name *

First Name Last Name

POC

Contact Role in Organization *

Phone Number *

- Area Code Phone Number

What is the best way to reach you? If by phone, what is a good time/day to call? *

E-mail *

Estimated total number of children *

Grade Level Range of Students *

Are you interested in an outreach program or a field trip to the MESS Hall? *

Outreach Summer Field Trip

Program Type

Number of days

Based on the number of children, you should plan on {numberOf} days of field trips. Please select dates accordingly.

Date of Trip *

May29

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Deposit Waiver Code (if issued)

Waiver

Deposit required

Deposit payment due

USD CampFieldTripDeposit

Field Trip Date Chosen

Please acknowledge the following key points for your field trip. By clicking submit, you are agreeing to abide by the requirements listed.

If this trip is cancelled 1 to 4 calendar days before the field trip is scheduled to occur (includes the weekend), future trips by this organization will incur a $25 cancellation fee.

*

Field trips must arrive between 9:30 and 9:45. If the group arrives significantly later than that, admission may be refused.

*

Field trips last 1.5 hours. Your group should plan on leaving by 11:00 - 11:15 am.

*

1 chaperone per 5 students entering grades 1-3, and 1 per 10 in grades 4 and up are required. If an insufficient number of chaperones accompanies the group, the group may be turned away. Chaperones are expected to monitor behavior of the group. If students are poorly behaved, the group may be asked to leave with no refund of fee.

*

Minimum group size is 10, maximum is 25.

*

Mission: The Universe

Go on a space trip! Explore the tools needed to discover the wonders of the universe in this NASA funded experience including an interactive science show and hands on stations.

Program is 1 1/2 hours and includes an approximately 30 minute presentation followed by 1 hour of hands on stations for up to 50 campers in grades K-6. If you have a larger program, we can schedule an additional hour of exploration for an addition group.

Fee: $250 for up to 50 students; $75 for each additional hour of hands on exploration for up to 50 students.

Travel Fee: For outreach programs outside of Escambia and Santa Rosa County a travel fee of $0.65 / mile will be added.

Want to book more than one show? Contact us at Groups@pensacolamesshall.org for additional offerings.

Possible program dates (choose no more than 3 options) *

Dates with Limited Availability are those where we already have a program, but, depending on the time and type of program, we may be able to schedule a program for your group.

Preferred time period *

Morning Afternoon Evening

Please provide information about the facility where the program will occur (e.g., is there a stage, is it a cafeteria, are there fixed tables or seats) *

Is there anything else we should know about your group?

Bookkeeper Email *

example@example.com