Field Trip Reservation Request Form Name:* First Last Email:* Phone* Best Time to Reach You:* : Hours Minutes AM PM AM/PM School or Group:* Formal School Homeschool Other group (bus tour, adults, scouts, clubs etc.) Group/School Name:* Has your group been to Great Lakes Aquarium before?* Yes No Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Please select the type of visit you are interested in:* Explorer: Exhibit exploration only (plan for 1.5-2 hours) Dive in Deeper: Exhibit exploration PLUS a one hour class (plan for 2.5-3 hours) This field trip is part of the Rivers2Lake program with the LSNERR. This field trip is part of the ISD 709 ECFE program. Rivers2Lake teachers must coordinate their field trip date with their Rivers2Lake mentor prior to booking their field trip at the Aquarium.* I have already confirmed the date/time of my field trip with my Rivers2Lake mentor. We have several options for a one-hour class with our Learning Team. Which class are you interested in?*A complete list of classes and descriptions can be found here. Please be aware that there is a 25-student maximum for most classes.* Up to three classes can be facilitated at a time, contingent on staff/space availability. *Behind the Scenes Tours have a maximum of 15 people, including adult chaperones. My group does not require a class.Not quite sure, I need more information.Animal Encounter ($50 flat fee for each encounter)Busy, Busy Bees (PreK)Fantastic Frogs (grades K-2)Snouty Seahorses (grades K-2)Creature Feature (1-3)Stories in Stone (grades 1-8)Water on the Move (grades 3-5)Run for your Life Cycle (3-8)Lake Superior Ecology (grades 3-12)Behind the Scenes Tour (grades 3-12)Lake Superior Limnology (grades 6-12)Conservation on the Brain (grades 9-12)Request an AnimalSelect your preferred animal from the options below -- choices are not guaranteed because of changing animal care considerations, but we will do our best to accomodate your first preference. Aquarium staff will be able to confirm your encoutner animal on the day of your visit. Mammal (possible species include striped skunk and chipmunk) Snake (possible species include ball python and corn snake) Invertebrate (possible species include giant African millipede, Madagascar hissing cockroach, and walking stick) Turtle (possible species include painted, wood, blandings, and red-eared slider) American Alligator Date of Visit*First Choice:Second Choice:Third Choice: Prefered Arrival Time for Visit*Dive in Deeper 1-hour classes are offered Monday- Friday. Please plan to arrive at least 15 minutes before a class start time to allow for a group welcome and transitions.First Choice:Second Choice:Third Choice: Preferred Departure Time:*At what time do you plan to leave the Aquarium? Grade Level of Students/Participants:* Number of Students:*Are these students divided into more than one classroom group?*I.e. "Our school's four fifth grade classrooms are all attending this field trip together." Yes No Number of Classroom Groups* Name of Each Classroom Group*i.e. "Ms. Henley's class, Mr. Smith's class;" "Red team, Blue team;" etc. This will help Aquarium educators communicate with students as they divide into groups. Number of School Staff (Teacher, Aide, Para, Admin):* Number of additional adult chaperones:*PLEASE READ: We require a chaperone ratio of 1 adult per 5 students for grades PreK-8, and 1 adult per 10 students for grades 9-12. Groups with fewer than the required chaperone ratio may be restricted from areas like the touch pools and gift shop. Lunch Plan:* Outdoors (on Aquarium grounds or at neighboring park) No Lunch Our Preferred Lunch Time* Method of Payment That Will Be Used (please note: payment for your group must be made in one lump sum, including all students and chaperones. Individual payments will not be accepted.):* Will your group be visiting the gift shop?*Yes Please! We will help our students and chaperons plan ahead.Not on this visit.We are still deciding, but will let you know before our visit.What goals or objectives do you have for your visit?*We offer a variety of books, curricula, and kits that can be used before a visit to build excitement or as a follow up to build on your aquarium experience. Our education department is happy to make recommendations based on your learning goals. Check out the tools available in our Teacher Resource Library. An extension of our classroom unit on...(please list topics below) Specific skill development (ie. writing, drawing, matching, math, etc.) A reward/novel experience for students A field study - observation/data collection A part of a service learning project Other - Please explain below Are there any special considerations that apply to your group (i.e. individuals in wheelchairs, breastfeeding mothers who may require access to a private room for pumping, hearing or vision impairments, etc.)?Please use the space below to share other important information about your group.