First Name *
Last Name *
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Thank you for choosing the Museum of Discovery & Science for your upcoming school field trip. If you have any questions when completing this form, please call us at 954.713.0930 or email firstname.lastname@example.org. Our guest experience specialists will be happy to assist you.
Will you be the onsite point of contact/lead teacher on the date of this field trip?*
Yes, I am planning to come to the Museum with the groupNo, someone else will be the onsite point of contact on the day of the field trip
Please provide the lead teacher’s name, cell number and email address.
Enter additional teacher or administrator email addresses (separated by commas)
Does your school receive Title 1 funding?*
Grade Level of Students Attending:*
Number of Students Attending Field Trip:*
Corresponding Number of Included Chaperones (Any adult including teachers, parents, legal
guardians, grandparents or siblings 18 and older). *Please note required ratios: PreK - Grade One
is 1:5, Grades Two and higher is 1:10.
Number of Expected Additional Chaperones
The Museum of Discovery and Science is dedicated to providing a memorable experience for all students, including those with special needs. Please help us prepare for your visit by telling us about your students and any modifications or accommodations they may require. Your answer will not affect your ability to participate. Please check any of the categories below that apply to your students.
---GiftedELL/ESOL (English Language Learners/English For Speakers Of Other Languages)Advanced Placement Program (Ap)Wheelchair Accessibility or Orthopedic ImpairmentAutism Spectrum Disorder (Asd)Montessori EducationDeaf/Hard of HearingEmotional/Behavioral DisabilityIntellectual DisabilityHonors ClassSpeech or Language ImpairmentLow or No Vision
Does your group have any accessibility needs or require any special accommodations that are not listed above or require further explanation? Please let us know so we can better plan your visit.
Please list below, in order of preference, the date your group would like to visit the Museum of Discovery and Science.
Please Select Your Field Trip Details:*Please refer to our Educator Resource Guide pages 8–19 for program selections by grade.All field trip options with the exception of IMAX Immersion include general Museum admission. ---ULTIMATE MODS MAKER • $20COMPLETE MUSEUM ADVENTURE • $18MUSEUM AND IMAX • $16ENHANCED MUSEUM EXPERIENCE • $13MUSEUM EXPLORATION • $11IMAX IMMERSION • $7
Please provide a quote for preordered box lunches (Please note: Lunches must be ordered at least 7 days in advance. Minimum quantity of 10)We will bring our own lunches in coolers.
Thank you for choosing the Museum of Discovery & Science for your upcoming school field trip. We look forward to hosting you and your group. In order to ensure a high-quality group experience, please note the following:
If you reschedule your date, you will be charged a $25 rescheduling fee. Rescheduling cannot be guaranteed due to limited availability.
Cancellation, "No Shows", and Refunds:
MODS aims to be inclusive for all our visitors. If your group requires special accommodations, call us at 954.713.0930 or email us at email@example.com for assistance as soon as possible in advance of your field trip date.
Day of Arrival and Check-In Information:
Buses and Parking: NEW POLICY! IMPORTANT-PLEASE NOTIFY YOUR BUS COMPANY:
By clicking below, you acknowledge your agreement with the MODS field trip policies.
Please call or email with any questions: 954.713.0930 or firstname.lastname@example.org.
Thank you. We look forward to seeing you soon at the Museum!
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