Lead Teacher/Contact Person's Name *

First Name

Last Name

Organization Postal Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Is Your School: *

Public

Private

Charter

Homeschool

Lead Teacher or Contact Person Daytime Phone Number *

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I fully understand that the Field Trip On Site Visit Guide (sent with the tentative date email) is required to be shared with all chaperones and general admission guests who will be attending the field trip in advance; before the actual date of the field trip so that they can prepare for their visit.

I agree to share the Field Trip On Site Visit Guide with all chaperones and general admission guests before the date of the field trip.

Please list your desired field trip date in order of preference (Tuesday - Friday ONLY). *

*Please note that some dates are exhibit transition periods. During these dates you can book up to 96 students w/lab

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I fully understand and agree to the policy that children ages 4 and under and strollers are not permitted in the lab due to safety reasons. I will inform Teachers and Chaperones in advance of this policy. *

If we are participating in an optional lab, I fully understand and agree to this policy.

I understand that Western Science Center Field Trips are self–guided and it is my responsibility to plan and distribute this information to all teachers and chaperones attending the Field Trip(s). *

I understand and agree

By submitting this request form, I consent to and authorize, without further compensation, the use and reproduction of any and all photographs taken of the Field Trip(s) and of anyone associated with the Field Trip(s). All digital copies remain the property of the Western Science Center. *

I understand and agree

I understand that arriving later than our scheduled time may result in a shortened program and we may not be able to participate in all activities, including labs (if scheduled). I understand that we may not receive field trip coordination in the event of a late arrival. I understand that no refunds or discounts will be given in the event of a late arrival. I understand that morning field trip check in begins promptly at 9:30 am and afternoon field trip check in begins promptly at 1:45 pm. I understand that the field trip is considered late if we arrive 15-minutes or later than our scheduled check in time as confirmed by the field trip tentative date email. I understand that the Western Science Center schedules staff, volunteers and other field trips based on our reservation time and therefore late arrivals can affect the field trip services we receive. *

I understand and agree

I understand and will inform all teachers, chaperones and students that lunchtime is at 11:45 am for A.M. (9:30 am) visits and will plan accordingly (for example, a snack before arrival, etc...). I understand that WSC schedules staff, volunteers and other field trips based on the scheduled time of the field trip and therefore this cannot be changed. *

I agree and understand that A.M. (9:30 am) field trips are scheduled for lunchtime at 11:45 am and that this cannot be changed

I understand that payment in full is required a minimum of two weeks prior to the Field Trip date(s) and that WSC does not provide refunds or accept purchase orders as forms of payment. Memberships and/or other admission passes/coupons cannot be used for field trips. I understand that failure to pay in full by the due date stated on the invoice will result in the field trip(s) being cancelled and that I will receive a cancellation notice via email. I understand that if the field trip(s) are not paid for in full by the due date that my field trip date(s) will be reassigned to another school on the field trip waitlist. I understand that a purchase order cannot be used to “hold” my field trip reservation as it is not considered a form of payment to the Western Science Center. *

I understand and agree

I understand that if we opt to show up after failure to pay for a field trip in full by the due date stated on the invoice, it will result in the school being charged the group rate ($5.00 per person with a minimum of 20 guests, ages 5 and up), with no lab or field trip coordination available and a field trip that was waitlisted may be on site. *

I understand and agree

I understand that field trip(s) will be charged a $25.00 fee for each returned check. *

I understand and agree

I understand that the field trip cannot begin until payment has been verified for accuracy, all additional tickets have been purchased, and final counts of all field trip guests including children 4 years old and under, have been processed with the Admissions staff. The field trip cannot begin until all members of the field trip party, including but not limited to, teachers, chaperones, students and general admission guests are present. All members of the field trip party must be present within 15-minutes of the scheduled check-in time to avoid losing field trip services.

I understand and agree

I hereby release the Museum authorities, staff, and volunteers from responsibility for accident or injury which may occur due to the negligence or disobedience of field trip participants. In the event of a medical emergency, museum officials have permission to seek medical assistance at the expense of the field trip participants involved. I understand that if field trip participants commit an offense that would normally cause removal from the Museum/Lab while participating in this activity, the field trip will be immediately removed from the Museum/Lab, and will not be permitted to return. No refunds of field trip fees will be given in the event of removal from the Museum/Lab. *

I understand and agree

By submitting this form, I understand that the Western Science Center reserves the right to cancel or reschedule Field Trip(s) at any time, for any reason. *

I understand and agree

By submitting the Western Science Center Field Trip Request Form online, you have agreed to the terms and conditions stated in the 2021/2022 Cancellation and Rescheduling Policies page located in the 2021/2022 Self-Guided Field Trip Guidelines for all Teachers, Chaperones, Drivers and School Administrators. *

I understand and agree

By submitting this Field Trip Request Form, I, and on behalf of all teachers, chaperones and general admissions guests of the field trip, have agreed to all policies stated in the 2021/2022 Contract & Policy Agreement, Field Trip Request Form and 2021/2022 Self-Guided Field Trip Guidelines for all Teachers, Chaperones, Drivers and School Administrators (including the Field Trip On Site Visit Guide).

I fully understand and agree