LASM 2012 Summer Reservation Form
ONLINE INSTRUCTIONS
1.
Complete the summer reservation form with your information and press the
SEND
button.
2.
Please complete a separate form for each visit.
3.
*Items marked with a red asterisk are required.
4.
After we receive your form, you will receive a confirmation stating the date, time, schedule, cost per person, and deposit information. Please allow up to three business days to receive your confirmation.
5.
Your reservation is
NOT
final until you fax a
SIGNED
copy of your confirmation to LASM at 225-214-1445.
GROUP INFORMATION
*
Group Name
*
Address
*
City
*
State
*
Zip Code
*
Phone Number
Fax Number
*
Contact Person
*
Contact's E-mail
GUEST INFORMATION
*
Number of Children
*
Age Range
to
*
Number of Chaperones/Adults
I have children with special needs
Yes
No
If yes, please let us know what special accommodations we should make:
DATE OF VISIT (Note, LASM is closed on Mondays)
*
First Date Choice
(mm/dd/yyyy)
*
Second Date Choice
(mm/dd/yyyy)
*
Arrival Time
*
Departure Time
How would you like to receive your confirmation?
Fax
Email
Mail
If you are unable to take advantage of your scheduled visit to The Museum Store at LASM, please comment:
PROGRAM TITLE
Planetarium Shows
$3.50/person
none
Kaluoka'hina: The Enchanted Reef
We Choose Space
Wild Ocean
Wildest Weather in the Solar System
Auditorium Interactive Programs
$3.50/person
none
The Colors of the Rainbow
Miss Trudy's Traveling Trunk Show
Shake, Rattle, and Roll
Weatherwise
Auditorium Films
$3.50/person
none
Forces of Nature
Lewis & Clark: Great Journey West
To Be an Astronaut
Whales: An Unforgettable Journey
Museum Gallery Add-ons
$0.50/person per gallery
Museum Gallery Add-ons are available for $.50 per child and chaperone for each Gallery. Please select from the following:
Ancient Egyptian Gallery
Art Gallery (closed June 25-29)
Discovery Depot
Science Station
Solar System Gallery
Additional Comments
We recommend that you print this page before clicking the
SEND
button.