Field Trip Inquiry Form CONTACT INFORMATIONSchool / Organization Name* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Name* Phone* Email Address* DAY OF VISIT CONTACT INFORMATIONName* Cell Phone Number* (Cell phone is in case we need to reach you en route)Email Address* Best time to reach you?* PROGRAM INFORMATIONNumber of Students* (Minimum of 15 Required)Grade Level / Age of Students* Number of Adult Chaperones (including teachers)* (must have a 1:5 ratio and must be 18 or older)Names of Teachers Attending* Field Trip Type* Field Trip Field Trip + Enrichment Class * 1 free chaperone admission with every 5 paid student admissions. (Discount only applies if group meets minimum required attendance and ratio.) Discount applied day of the field trip.Name of Enrichment Class SCHEDULEPreferred Dates* Preferred Arrival Time: Weekdays* 9:15 9:45 10:15 10:45 11:15 or Later Approximate Departure Time* Arrival By:* Bus Individual Cars Will you be eating lunch or snack at the Museum? Yes No PAYMENT INFORMATIONPayment will be made by* Credit Card Purchase Order - Prior authorization required How did you hear about us?-- Select One --At MuseumImagine eNewsNewsletterProgram GuideSchoolIMAGINE CHILDREN'S MUSEUM VISIT CONTRACTTo ensure a successful visit, please review and check each item below. Your online submission of this form constitutes your agreement to each of the following terms. If you have any questions, please email reservations@imaginecm.org, or call 425/258-1006, Ext. 1012 on weekdays from 9:00 a.m. - 5:00 p.m.* A 50% non-refundable deposit is required at scheduling; remaining balance is due day of Field Trip or services. On the day of Field Trip or services, only one payment may be made per group. Group pricing cannot be combined with any other discounts. Memberships are not applicable for free admission when associated with a group visit. Imagine requires a 1:5 adult to child ratio. Groups may be denied or limited entry if they are lacking the appropriate number of chaperones. Failure to meet the 1:5 ratio will result in a loss of a discount or the group being denied entry. Late arrivals may result in delayed entrance into the Museum. If you are late your program may be shortened or canceled; you are still responsible for the balance due. We reserve the right to ask any disorderly group to leave the building without refund. Your organization is responsible for damage to the Museum while visiting. Chaperones are responsible for the behavior of students and required to accompany their assigned students at all times. Participants must follow the Museum's current COVID policy. Comments (special needs, etc.)Captcha Field Trip Inquiry Form