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School or Youth Group Reservation

2. Name of School or Youth Group*

4. School/Group Mailing Address*

6. City*

7. State*

8. Zip Code*

10. Your Name*

12. Your Phone*

13. Your Email*

14. Office Number*

16. Method of Payment*
    -- Select One --CashDebit/creditPurchase Order (must be provided by the visit date)

    * Unable to accept pre-written checks.
    

17. Tax Exempt?*

    1. Yes
    2. No

18. Tax Exempt Number

20. Day-Of Emergency Contact

    If you are not attending field trip, please list the name and phone number of at least one person we may contact in the event of a lost child or other emergency.

24. When would you like to visit?
    Please allow up to 2 weeks to receive email confirmation of your trip. Email confirmation is required in order to receive field trip admission rates.

    Please allow up to 2 weeks to receive email confirmation of your trip. Email confirmation is required in order to receive field trip admission rates.

26. Preferred Visit Date*
    Preferred Visit Date

27. Arrival Time*
    -- Select One --10:00 AM10:15 AM10:30 AM10:45 AM11:00 AM11:15 AM11:30 Am11:45 AM12:00 PM12:15 PM12:30 PM12:45 PM1:00 PM1:15 PM1:30 PM1:45 PM2:00 PM2:15 PM2:30 PM2:45 PM3:00 PM3:15 PM3:30 PM3:45 PM4:00 PM or later

28. Estimated Departure Time
    -- Select One --11:00 AM or earlier11:15 AM11:30 AM11:45 AM12:00 PM12:15 PM12:30 PM12:45 PM1:00 PM1:15 PM1:30 PM1:45 PM2:00 PM2:15 PM2:30 PM2:45 PM3:00 PM3:15 PM3:30 PM3:45 PM4:00 PM4:15 PM4:30 PM4:45 PM5:00 PM5:15 PM5:30 PM5:45 PM6:00 PM or later (Tuesdays only)

30. Alternative Visit Date
    Alternative Visit Date

31. Arrival Time for Alt. Date
    -- Select One --10:00 AM10:15 AM10:30 Am10:45 AM11:00 AM11:15 AM11:30 AM11:45 AM12:00 PM12:15 PM12:30 PM12:45 PM1:00 PM1:15 PM1:30 PM1:45 PM2:00 PM2:15 PM2:30 PM2:45 PM3:00 PM3:15 PM3:30 PM3:45 PM4:00 PM or later

32. Estimated Departure for Alt. Date
    -- Select One --11:00 AM or earlier11:15 AM11:30 AM11:45 AM12:00 PM12:15 PM12:30 PM12:45 PM1:00 PM1:15 PM1:30 PM1:45 PM2:00 PM2:15 PM2:30 PM2:45 PM3:00 PM3:15 PM3:30 PM3:45 PM4:00 PM4:15 PM4:30 PM4:45 PM5:00 PM5:15 PM5:30 PM5:45 PM6:00 PM or later (Tuesdays only)

34. Grade Level/Age Range of Group*

    Select all that apply to your group.

    1. Pre-K (3-5 yrs)
    2. K (5-6 yrs)
    3. 1st (6-7 yrs)
    4. 2nd (7-8 yrs)
    5. 3rd (8-9 yrs)

    1. 4th (9-10 yrs)
    2. 5th (10-11 yrs)
    3. 6th (11-12 yrs)
    4. 7th (12-13 yrs)
    5. 8th (13-14 yrs)

    1. 9th (14-15 yrs)
    2. 10th (15-16 yrs)
    3. 11th (16-17 yrs)
    4. 12th (17-18 yrs)
    5. College (18 yrs+)
36. Expected Number of Students*

38. Expected Number of Chaperones*

    The number of required (free) chaperones plus any other adults your group is paying for.

39. How many additional parents/chaperones will be joining your group?

    This number is only used to predict visitor capacity for the day; it does not affect your group's price.

43. Programs and Tours
    Click here for descriptions, pricing, and group size and age restrictions.

45. Program
    -- Select One --NoneCompletely Cartilaginous: All About Sharks (Add $3/student)Sea Turtle Science (Additional $3/student)

46. Behind-the-Scenes Tour
    -- Select One --NoneSwim into Science (3rd-6th grade only)- Additional $3/studentThe Inside Story (must be 7th grade/12 yrs and older)- Additional $3/student

47. How many tour groups do you need?
    -- Select One --1 group (25 people)2 groups (up to 50 people)3 groups (up to 75 people)

49. Feed the Animals?

    Groups may reserve a maximum of 50 cups per feed stand.

    1. Yes
    2. No
50. Turtle Feed Cups ($3 each)
    -- Select One --01234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950

51. Stingray Feed Cups ($4 each)
    -- Select One --01234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950

53. Additional Notes

    List any comment, special needs or accessibility concerns here.

Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit