Register Your Kaleideum Field Trip Online! (School Groups) Fields marked with an * are required. Please complete the form below and submit your request to Kaleideum. The Kaleideum Museum Scheduling Coordinator will contact you to confirm your request. Reservations are not confirmed until you receive a confirmation email from Kaleideum. Thank you for choosing to spend your day at Kaleideum! For more information and descriptions of each field trip, please visit north.kaleideum.org and download the Kaleideum Educators' Guide under Field Trips. Which location would you like to visit?*Kaleideum NorthKaleideum Downtown GROUP TYPE DESCRIPTIONS Winston-Salem/Forsyth County Schools Student and teacher admission is free. One chaperone per five students is admitted free ($6 per adult charge thereafter). Bus drivers are admitted free. Additional charges per person/per program apply. School Groups and Home School Groups outside Forsyth County $4 per student admission. Teacher admission is free. One chaperone per five students is admitted free ($6 per person charge thereafter). Bus drivers are admitted free. Additional charges per person/per program apply. School Groups (non WS/FCS) and Home School Groups within Forsyth County $2 per student admission. Teacher admission is free. One chaperone per five students is admitted free ($6 per person charge thereafter). Bus drivers admitted free. Additional charges per person/per program apply. Preschool or Child Care Group $2 per student admission. Teacher admission is free. One adult free per five children ($6 per person charge thereafter). Bus drivers admitted free. Additional charges per person/per program apply. Public Group Ages 11 months and under are free. $7 per person for youth ages 1-19, adults, and seniors. One chaperone per 10 students is admitted free. Bus drivers are admitted free. Additional charges per person/per program apply. GROUP TYPE DESCRIPTIONS Winston-Salem/Forsyth County Schools Student and teacher admission is free. One chaperone per 10 students is admitted free ($6 per adult charge thereafter). Bus drivers are admitted free. Additional charges per person/per program apply. School Groups and Home School Groups outside Forsyth County $6 per student admission. Teacher admission is free. One chaperone per 10 students is admitted free ($6 per person charge thereafter). Bus drivers are admitted free. Additional charges per person/per program apply. School Groups (non WS/FCS) and Home School Groups within Forsyth County $4 per student admission. Teacher admission is free. One chaperone per 10 students is admitted free ($6 per person charge thereafter). Bus drivers admitted free. Additional charges per person/per program apply. Preschool or Child Care Group $4 per student admission. Teacher admission is free. One adult free per five children ($6 per person charge thereafter). Bus drivers admitted free. Additional charges per person/per program apply. Public Group Ages 11 months and under are free. $7 per person for youth ages 1-19, adults, and seniors. One chaperone per 10 students is admitted free. Bus drivers are admitted free. Additional charges per person/per program apply. School/Group Name*Name of Primary Contact* First Last Email of Primary Contact*Note: Due to some technical difficulties, if you operate within the gcsnc.com email system, please provide an alternate email address. School Phone Number*Primary Contact Phone NumberAddress*A bill will be sent to this address if invoice is unpaid at the time of the visit. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountyForsythDavidsonDavieGuilfordRockinghamStokesSurryYadkinGrade Level*Number of Visiting Students*Total Number of Visiting Classes*Number of Teachers*Please list the name of the Lead Teacher of each class*Separate names by a commaNumber of Parent Chaperones*Date Requested - First Choice* Date Requested - Second Choice Date Requested - Third Choice Arrival Time* : HH MM AM PM Departure Time* : HH MM AM PM Are you planning on having lunch at the Museum?*IMPORTANT! Lunch at Kaleideum North is held in FoodWorks. Space is first come, first serve and cannot be reserved. Please plan accordingly. YesNoUndecidedWill space be needed for lunch?*IMPORTANT! Space is limited at Kaleideum Downtown, so we will need to know in advance if your group is expecting to eat lunch at our facility in order to prepare space for the students. YesNoPlease choose your group type*Winston-Salem/Forsyth County Public School GroupSchool Group or Home School Group outside Forsyth CountySchool Group (non WS/FCS) or Home School Group within Forsyth CountyPreschool or Child Care CenterPublic GroupProgram 1 (Each program is $5.50 per visitor.)Legos & Lights (Grades PreK-2)Sounds All Around (Grades PreK-2)The Greedy Triangle (Grades K-2)Fur, Feather, Scale & Slime (Grades PreK-5)Weather Wonders (Grades K-5+)Melting Pot (Grades K-5)Potions in Motion (Grades K-6+)Magnificent Magnets (Grades 1-4)Earth, Moon & Stars (Grades 1-6)Science Extravaganza (Grades 1-6)Electricity & Light (Grades 3-6+)The Navigators (Grades K-2)Planetarium: Discovering the Earth, Moon & Sun (Grades K-1)Planetarium: Astro Moose Goes to Space (Grades K-3)Planetarium: Star Songs (Grades K-4)Planetarium: Tour of the Seasons (Grades K-6)Planetarium: Solar System Tour (Grades 1-6)Planetarium: Follow the Drinking Gourd (Grades 1-6+)Planetarium: Space in Motion (Grades 2-6)Planetarium: Carolina Skies (Grades 3+)Planetarium: From Earth to the Universe (Grades 5+)Planetarium: Space Voyagers (Grades 5+)Planetarium: All About the Cosmos (Grades 6+)Environmental Park Tours: Habitat Helpers (Grades K-6+)Off-site: Geology at Work (Grades K-6+)Number of StudentsProgram 2 (Each program is $5.50 per visitor.)Legos & Lights (Grades PreK-2)Sounds All Around (Grades PreK-2)The Greedy Triangle (Grades K-2)Fur, Feather, Scale & Slime (Grades PreK-5)Weather Wonders (Grades K-5+)Melting Pot (Grades K-5)Potions in Motion (Grades K-6+)Magnificent Magnets (Grades 1-4)Earth, Moon & Stars (Grades 1-6)Science Extravaganza (Grades 1-6)Electricity & Light (Grades 3-6+)The Navigators (Grades K-2)Planetarium: Discovering the Earth, Moon & Sun (Grades K-1)Planetarium: Astro Moose Goes to Space (Grades K-3)Planetarium: Star Songs (Grades K-4)Planetarium: Tour of the Seasons (Grades K-6)Planetarium: Solar System Tour (Grades 1-6)Planetarium: Follow the Drinking Gourd (Grades 1-6+)Planetarium: Space in Motion (Grades 2-6)Planetarium: Carolina Skies (Grades 3+)Planetarium: From Earth to the Universe (Grades 5+)Planetarium: Space Voyagers (Grades 5+)Planetarium: All About the Cosmos (Grades 6+)Environmental Park Tours: Habitat Helpers (Grades K-6+)Off-site: Geology at Work (Grades K-6+)Number of StudentsProgram 3 (Each program is $5.50 per visitor.)Legos & Lights (Grades PreK-2)Sounds All Around (Grades PreK-2)The Greedy Triangle (Grades K-2)Fur, Feather, Scale & Slime (Grades PreK-5)Weather Wonders (Grades K-5+)Melting Pot (Grades K-5)Potions in Motion (Grades K-6+)Magnificent Magnets (Grades 1-4)Earth, Moon & Stars (Grades 1-6)Science Extravaganza (Grades 1-6)Electricity & Light (Grades 3-6+)The Navigators (Grades K-2)Planetarium: Discovering the Earth, Moon & Sun (Grades K-1)Planetarium: Astro Moose Goes to Space (Grades K-3)Planetarium: Star Songs (Grades K-4)Planetarium: Tour of the Seasons (Grades K-6)Planetarium: Solar System Tour (Grades 1-6)Planetarium: Follow the Drinking Gourd (Grades 1-6+)Planetarium: Space in Motion (Grades 2-6)Planetarium: Carolina Skies (Grades 3+)Planetarium: From Earth to the Universe (Grades 5+)Planetarium: Space Voyagers (Grades 5+)Planetarium: All About the Cosmos (Grades 6+)Environmental Park Tours: Habitat Helpers (Grades K-6+)Off-site: Geology at Work (Grades K-6+)Number of StudentsLaser Show - $1.50 each if part of a planetarium show. $2.50 if purchased alone.Fun RockCosmosMonsters & MermaidsHalloweenMannheim Steamroller ChristmasClassic RockNumber of StudentsWill this group participate in a Kaleideum Program?*Each program is $5.50 per visitor. View our Educators' Guide for more information about programs here. YesNoSelect a Program*Legos & Lights (Grades PreK-2)Sounds All Around (Grades PreK-2)The Greedy Triangle (Grades K-2)Grow (Grades PreK-1)The Navigators (Grades K-2)Curator's Crisis (Grades K-3)Peppercorn Main Stage Show: "Alice in Wonderland" {Grades PreK+) Please check this if your school is a Title 1 school Please check this if you are a Head Start Program Additional comments, questions, or concerns:Once you hit "Submit," you will receive an automatic email confirmation. If you have not received an automatic email confirmation from Kaleideum within 48 hours, please contact Christy Ferguson at (336) 714-7105. Important! Your field trip or group visit to Kaleideum Downtown is not confirmed until you receive a confirmation letter from Christy Ferguson, the Kaleideum Museum Scheduling Coordinator. Please bring this confirmation letter with you to present to the front desk when you come. If you do not receive your letter within one week of booking your visit, please contact Christy via email or phone at (336) 714-7105.Once you hit "Submit," you will receive an automatic email confirmation. If you have not received an automatic email confirmation from Kaleideum within 48 hours, please contact Christy Ferguson at (336) 714-7105. Important! Your field trip or group visit to Kaleideum North is not confirmed until you receive a confirmation letter from Christy Ferguson, the Kaleideum Museum Scheduling Coordinator. Please bring this confirmation letter with you to present to the front desk when you come. If you do not receive your letter within one week of booking your visit, please contact Christy via email or phone at (336) 714-7105.UntitledName First Last
