Family Science Night Application for 2017-18

Please note that applications MUST be submitted with the knowledge and consent of the school. All fields are required.

Is this application for a Title I School?
Yes No 

Point of Contact First Name

Point of Contact Last Name

Point of Contact Title

School/Organization

Address

City

State

Zip

Telephone

Email

County

Requested Dates:
Please enter six (6) dates in order of preference, on Tuesdays and Thursdays only, September 2017 through April 2018. We will do our best to accommodate your first request.

Date 1

Date 2

Date 3

Date 4

Date 5

Date 6

Where will the event be held? e.g. gym, cafeteria, or multi-purpose room


Submission of this form indicates that the school or organization agrees to the following obligations (please mark each box on the left of each item to signal understanding and compliance).

 I Agree to pay a flat fee of $600 to accommodate up to 350 visitors. Deposit of 20% ($120) is due at the time of scheduling your event date. The $480 balance is payable at the event.

 I Agree to provide 15 free-standing, 6-foot rectangular tables. I understand that cafeteria tables with attached seating or round tables are not permissible.

 I Agree to provide a minimum of 18 adult volunteers in a single shift to support the event between the hours of 5:00 – 8:30 p.m. Adult volunteers are considered 16 years or older. Due to liability restrictions, any volunteers younger than this minimum age requirement are not considered part of the minimum 18 volunteers requested and will not be assigned to an activity.

 I Understand that my volunteers must be on-site from 5:00 – 8:30 p.m. on the day of my scheduled event, and that splitting shifts between multiple groups of volunteers is disruptive to my event's logistics and will not be permitted.

 I Agree to provide volunteer contact information (names and email addresses, please) to the Children's Science Center NO LATER THAN 10 DAYS in advance of my scheduled event in order to ensure that each volunteer receives a station assignment and volunteer instruction packet in a timely manner. I agree not to make changes to these assignments without consulting the Children's Science Center first.

 I Understand that our school's volunteers must prepare in advance for the event by thoroughly reading the materials and viewing the related online video provided for their assigned activity, and should address any questions to the Children's Science Center well in advance of the event date as on-site training will not be readily available. I agree to reach out to the Children's Science Center in a timely fashion should I feel I need any assistance in preparing volunteers in advance of the event or desire to schedule a volunteer training session.

 I Agree to not permit food or beverages other than bottled water in the same room as the activities in order to prevent damage to the Center's materials and property.

 I Agree to provide the Children's Science Center access to the event space for 4 hours (5:00 – 9:00 pm).

 I Understand that Family Science Nights are only scheduled on Tuesdays and Thursdays from 6:00 – 8:00 p.m., September through April.

 I Consent to allow the Children's Science Center to take photos and/or video of my event, while respecting those students or parents who do not wish to have their photos or likenesses recorded.

 I Agree to provide a minimum of 8 weeks notice prior to canceling or requesting to reschedule an event. I understand that not all requests to reschedule an event can be accommodated.

 I Agree to participate in one or more of the communications activities listed above.

Failure to comply with these contractual obligations can lead to a forfeiting of your scheduled event, or ineligibility to participate in future events.


OPTIONAL SPECIAL PROMOTION: The Children’s Science Center Lab is offering a special promotion for schools that book a Spirit Night at the Lab for the 2017-2018 academic year by April 30, 2018. By indicating your willingness to plan a Spirit Night at the Lab below, your school will be entered in the priority blind drawing for Family Science Night! Spirit Nights are a brand new offering of the Center and a great way to continue the excitement for STEM learning in your school community as well as raise funds for your school.

Would you like to book a Spirit Night at the Children's Science Center Lab?

Yes No 

Note that your school is not obligated to reserve a Spirit Night unless your application is selected in the Family Science Night drawing. If selected, your school must complete booking of both events to secure your selection. If not selected, you may still book a Spirit Night for your school at any time.


By submitting this form, the point of contact agrees to be the responsible party for the obligations outlined in this agreement. In this web form, your typed signature is treated by the Children's Science Center like a physical handwritten signature on a paper form.

Full Name of Responsible Party (Will serve as your signature)

Signature Date