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| Contact Information: |
| Group Name:* |
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| Contact Name:* |
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| Contact Telephone:* |
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| Mailing Address:* |
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| City:* |
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| State:* |
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| Zip Code:* |
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| County:* |
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| Email Address:* |
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| Group Information: |
| # of Students:* |
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| # of teachers* |
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| # of Chaperones: |
(1:5 chaperone/student ratio required for on-site field trips.) |
| Student Grade Level:* |
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| Is your school Title 1?:* |
Yes No |
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What kind of program are you requesting? NOTE: You must select one of the following options! |
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Frontier Days: Wednesday, April 21: Schools outside the Bend/LaPine School District Frontier Days: Thursday, April 22: Bend/La Pine Grades K-3 Frontier Days: Friday, April 23: Bend/La Pine Grades 4-8 Discovery Class at the Museum: $175, 30 student maximum Discovery Class at Your Location: $200, 40 student maximum Self-Guided Museum Field Trip: $4.50, per student Discovery Tour: $7 per student, 20 student maximum
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Educational Programs: Check all that apply (To read more about the programs, click here.) |
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Discovery Classes: Creepy Crawlies Desert Dwellers Traveling the Applegate Trail Living off the Land Rockin' Geology Art Through Ancestry What's the Matter Birds of Prey Reptiles Fired Up!
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Discovery Tours: Technology from 17th - 21st Century High Desert Wildlife The Art of Adaptation Animal Keeper Care |
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| How do you plan to pay for your program(s)? |
Check Credit Card (We will contact you for this information) Purchase Order Cash Other (explain in comment section below)
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| When do you plan to pay for your program(s)? |
In advance; please bill me On the day of the program(s)
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| Date/Time Requests: |
| Please indicate your 1st, 2nd and 3rd choices for the date and time of your program. |
| Date: |
(MM/DD/YY) |
| Choice 1 |
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| Choice 2 |
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Choice 3 |
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| Arrival Time: |
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Program Time: |
| Choice 1 |
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| Choice 2 |
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| Choice 3 |
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During seasons of inclement weather, a lunchroom will be assigned to your group at a scheduled time at no cost. During seasons of clement weather, your group may enjoy lunch outdoors within various picnic locations. |
Please explain, in detail, any special requests or concerns you have regarding your registration: |
| Please remember, once you submit this form and your registration is confirmed, changes or cancellations are subject to administrative fees. |
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