Register Your Kaleideum Field Trip Online! 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! School Group Admission Winston-Salem/Forsyth County School System Students: Free All other Forsyth County Students: $5 Preschool Students: $5 Out of County School Students: $7 Teachers: Free Bus Drivers: Free **Additional family members are welcome to visit the museum but will be required to pay full price and are not allowed into the group’s scheduled education programs or planetarium shows. Education Program Fees* (per person) PreK-12th Grade Programs: $6 Digital Dome Programs $6 Laser Shows: $2 WSFCS Title 1 schools receive one free program per group per year. *NC sales tax included on admission. Program fees are not taxed. 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. YesNoUndecidedPlease 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 GroupWill this group participate in a Kaleideum Program?*Each program is $6 per visitor. View our Educator's Guide for more information about programs here. YesNoProgram 1 (Each program is $6 per visitor.)Changing Seasons (Grade K-2)Energy Explorers (Grade 4-6)Fur, Feathers, Scale & Slime (Grade K-2)Greedy Triangle (Grade PreK-K)Shadows & Lights (Grade PreK-1)Magnificent Magnets (Grade 1)Marvelous Matter, Mixtures, & More (Grade 3-5)Sounds All Around (Grade PreK-2)What's the Matter? (Grade K-3)Geology at Work (Grade K-6+) (Offsite)Number of StudentsProgram 2 (Each program is $6 per visitor.)Changing Seasons (Grade K-2)Energy Explorers (Grade 4-6)Fur, Feathers, Scale & Slime (Grade K-2)Greedy Triangle (Grade PreK-K)Shadows & Lights (Grade PreK-1)Magnificent Magnets (Grade 1)Marvelous Matter, Mixtures, & More (Grade 3-5)Shocking Discoveries (Grade 3-7)Sounds All Around (Grade PreK-2)What's the Matter? (Grade K-3)Geology at Work (Grade K-6+) (Offsite)Number of StudentsProgram 3 (Each program is $6 per visitor.)Changing Seasons (Grade K-2)Energy Explorers (Grade 4-6)Fur, Feathers, Scale & Slime (Grade K-2)Greedy Triangle (Grade PreK-K)Shadows & Lights (Grade PreK-1)Magnificent Magnets (Grade 1)Marvelous Matter, Mixtures, & More (Grade 3-5)Shocking Discoveries (Grade 3-7)Sounds All Around (Grade PreK-2)What's the Matter? (Grade K-3)Geology at Work (Grade K-6+) (Offsite)Number of StudentsPlanetarium Program 1 (Each program is $6 per visitor.)All About the Cosmos (Grade 5+)Carolina Skies (Grade 3+)Cosmic Adventures (Grade 3-5)Earth, Moon, and Sun (Grade K-1)MicroCosm (Grade 5+)Solar System Tour (Grade 1-6)Universe (Grade 5+)Zula Patrol (Grade PreK-2)The Great Space Chase (All Ages Laser Show)Musical Laser Special (All Ages Laser Show)Number of StudentsPlanetarium Program 2 (Each program is $6 per visitor.)Carolina Skies (Grade 3+)Cosmic Adventures (Grade 3-5)Earth, Moon & Sun (Grade K-1)MicroCosm (Grade 5+)Solar System Tour (Grade 1- 6)Universe (Grade 5+)Zula Patrol: Under the Weather (Grade PreK-2)The Great Space Chase (All Ages Laser Show)Musical Laser Special (All Ages Laser Show)Number of StudentsPlanetarium Program 3 (Each program is $6 per visitor.)All About the Cosmos (Grade 5+)Carolina Skies (Grade 3+)Cosmic Adventures (Grade 3-5)Earth, Moon & Sun (Grade K-1)MicroCosm (Grade 5+)Solar System Tour (Grade 1- 6)Space in Motion (Grade 2-6)Space Voyagers (Grade 5+)Tour of the Seasons (Grade 2-6)Universe (Grade 5+)Zula Patrol: Under the Weather (Grade PreK-2)The Great Space Chase (All Ages Laser Show)Musical Laser Show (All Ages Laser Show)Number of Students 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: