Night at the Museum (11/09/2019)
The Night at the Museum is a monthly drop-off program for kids (4- to 12-years-old). Kids will get to spend after hours in the museum playing with museum exhibits and engaging with staff-led activities. A pizza dinner is also provided.
Name of Child *
Your answer
Date of Birth *
Your answer
Parent or Guardian Name *
Your answer
Contact Email Address *
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Contact Phone Number *
Your answer
Contact Mailing Address *
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Emergency Contact Name *
In the event the above parent/guardian cannot be reached at the provided contact number, please provide a second contact that we may call.
Your answer
Emergency Contact Number *
Your answer
Any known allergies *
if none please type "none"
Your answer
Do you have any concerns you would like us to know about in advance?
Your answer
I agree to allow the Children's Science Museum to obtain medical care for my child in the event of injury. *
I agree to allow the Children's Science Museum to photograph my child. *
Please be sure to review our photo and video disclaimer found on our website for details.
Do you have an active membership with the Orpheum Children's Science Museum? *
If so, what is your membership number?
This number can be found in the lower right-hand corner of your membership card.
Your answer
How did you hear about our program?
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