Homeschool Booking Form

Group Information

Group Name

Main Contact Name(Required)

First Last

Email(Required)

Phone(Required)

Estimated Attendance(Required)

Groups must have a minimum of 10 participating students and a maximum of 60 students and adults. Final tally due week prior to visit.

Please enter a number from 10 to 60.

Is there anything we should know about your group to ensure you have the best experience at the Springfield Museums? (Learning styles, sensory and accessibility needs, etc.)

Date of Visit

First Choice(Required)

Arrival Time(Required)

:

Departure Time(Required)

:

Second Choice(Required)

Arrival Time(Required)

:

Departure Time(Required)

:

Third Choice(Required)

Arrival Time(Required)

:

Departure Time(Required)

:

Would you like to receive our monthly Educator E-newsletter?(Required)

Yes

No

Unless otherwise noted by the visiting school educator, submitting this form gives consent to the use of photographs/videotape taken during the course of a school program visit for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources).(Required)

The visiting school educator does this with full knowledge and consent and waives all claims for compensation for use, or for damages. If a single student or multiple students may not be photographed, please inform the school program coordinator.

Agree

Disagree

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