School Year Field Trip Request Application "*" indicates required fields Thank you for considering an In-Person Field Trip to Glazer Children’s Museum. If you have any questions about this form, please call Guest Services at 813-443-3821 or email reservations@glazermuseum.org. RATES | Children are $14 each. 1 chaperone FREE per 10 children. Additional adults are $14 each. *Rates apply to groups with a minimum of 15 children. RATES | Free with proof of Title 1 status, based on availability. *Title 1 field trip rates are offered from September to May, on Tuesdays and Wednesdays only.BOOKING | In-person field trips must be booked at least 1 week in advance of your earliest desired date. All bookings are made on a first-come, first-served basis. Booking is not complete until you receive a booking approval email from Glazer Children’s Museum.If you need to change a booked field trip date or the number of guests, please call Guest Services at 813-443-3821.Full School Name*Do you need to submit proof of Title 1 Status?* Yes No Proof of Title 1 Status* Drop files here or Select files Max. file size: 50 MB, Max. files: 10. County*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Are you a returning school?* Yes No Grade Level Attending* Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Other Other*Lead Contact Info (Must be attending trip)Lead Contact Name*(Must be attending trip) First Last Email* Phone*Alternative Contact Name* First Last Alternative Email* Alternative Phone*Number of children**Field trip pricing applies to a minimum of 15 children. Number of chaperones (School staff/adults) are $14 each.*The museum provides 1 Free Chaperone per every 10 students. This includes school staff members joining the field trip. Number of buses*Select your first preferred date (August 2025-May 2026) *Tuesdays or Wednesdays only** Month Day Year Select your second preferred date (August 2025-May 2026) *Tuesdays or Wednesdays only** Month Day Year Select your third preferred date (August 2025-May 2026) *Tuesdays or Wednesdays only** Month Day Year Select your desired time slot 10:00am-12:00pm 10:30am-12:30pm 11:00am-1:00pm 11:30am-1:30pm 12:00pm-2:00pm How will you be paying?* Check Card Cash