Visit Registration Form - Evergreen Aviation & Space Museum

Visit Registration Form
Contact
Information
How did you hear
about us?
Date submitted:
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_______________________________
Museum Contact: 500 NE Captain Michael Smith Way, McMinnville, OR 97128-Phone: 503.434.4185 Fax: 503.434.4188
Previous visit?
When?
(Please bring a copy on the day of your visit)
District/ Organization
Grade Level
School Name
# of Students
Teacher(s):
Phone:
Cell:
E-mail address:
Mailing address:
Admission Requested*:
Scholarship opportunities
1 Museum only: $8 per student
1 Movie only: $5.00 per student
Fill out scholarship application
1 Museum & Movie: $11 per student
and fax to 503.434.4188
2 Museums: $15 per student
(Attached)
Does not apply to Waterpark
2 Museums & Movie: $17 per student
Wings & Waves Waterpark: $22 per person ($12 non-swimmer)
*Teachers and bus drivers are free for Museums only, not Waterpark. Parent Chaperones are same rates as above.
Visit Information
Date of program
Time of Arrival:
Time of Departure:
Theater Movie Time (refer to times on):
http://www.evergreenmuseum.org/theater/
Movie Requested:
# of students with
# of students requesting
sack lunches
box lunches
*$5 ea/ Includes sandwich, fruit, and water or milk. Sandwich options: Turkey or Ham. Orders must be received at least 1 wk prior to visit.
PLEASE complete the MEDIA EXCLUSION Form ONLY for those NOT wishing to have their photo taken during the visit.
CANCELLATION POLICY: To cancel or reschedule your visit you must speak directly with the Education Scheduler (503) 434-4185. You
cannot cancel or reschedule your reservations by voice-mail or e-mail. You must cancel or reschedule your visit at least 14 days prior to
the scheduled date of the visit. Groups that reschedule a visit after the deadline will incur a processing fee of $20. Groups that cancel a
visit after the deadline will incur a $25 cancellation fee. No-shows for a visit will incur a $50 cancellation fee. Cancellation fees for noshows
due to adverse weather or “Acts of God” are addressed on a case-by-case basis.
500 NE Captain Michael King Smith Way McMinnville, OR 97128 Tel: 503.434.4185 Fax: 503.434.4188

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Standards Aligned, History & S.T.E.M. Centered Museum Education Programs:
Museum Programs – Please call for program description
Aviation Museum:
Check program you are interested in (30 minutes each unless otherwise indicated ):
Aviation Drawing and Sketching (call for availability)
o Aviation Myths Tour - Amelia Earhart, UFO’s & Aliens, Pearl Harbor, Howard Hughes
Flight/Ground School (All Grade Levels)
o Learn about the four forces of flight, airplane systems and navigation
Footlocker Activity (Grades 8 – 12)
o WWII Marine Raider ○ 101 st Airborne-D Day ○WWI British soldier ○Homefront- Rosie the Riveter
Glider Activity (All Grade levels)
History of Flight Tour (All Grade levels)
STEM Experience (1 st Grade ONLY) (1 hr 30 min)
Workshops: Activities Determined by day schedule/group size: (45 min to 1 hr program unless otherwise indicated)
Weather/ Navigation/Pre-flight Workshop (Grades 4-12) (2 hours)
Engineering Design/Invention Process Workshop (All grade levels)
Engineering Design – Wright Bros (Grades 4-12)
Engineering Design – Straw Towers (Grades 4-12)
Space Museum:
Check program you are interested in (30 minutes each unless otherwise indicated ):
STEM Experience (2 nd or 5 th Grade ONLY) (1 hr 30 min)
All About Helicopters (All grade levels)
o Learn how a helicopter flies, the different types and uses of this amazing machine
Living in Space (All Grade Levels)
o Learn how astronauts live and work in space
Moon Adventure (All Grade Levels)
o Learn how astronauts work on the moon
MAGIC PLANET - Our Solar System & Beyond (All Grades)
o Learn about our solar system and all its planets
Robotics (1 – 6 Grade) (1 hour) **** requires outreach at school prior to visit*****
o Lego Mindstorms robotics programming clinic with a robotics tour
Rockets & Newton’s Laws of Motion (All Grade Levels)
o Hands-on rocket-making and launching
Space Exploration Timeline Tour (All Grade Levels)
o Let about the first rockets, early space programs and manned space exploration
Titan II Simulation (Grades 5-12)
o Launch a Titan II rocket from mission control (12 students maximum)
All about UAVs – includes live drone demo (All Grades)
Wings & Waves Waterpark Education Programs
Check program you are interested in:
STEM Experience (3 rd , 4 th , 6 th or 7 th Grade ONLY) (1 hr 30 min)
Water Water Everywhere! (2 hours)
Topics include: The water cycle, watersheds, water pollution movement and prevention.
Mad about Water (1-2 hours)
Topics include: The properties of water, phases of water, water density experiments, and water conservation.
500 NE Captain Michael King Smith Way McMinnville, OR 97128 Tel: 503.434.4185 Fax: 503.434.4188

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Water- the Sustainer of Life (2 hours)
Topics include: The importance of water, water management, where our drinking water comes from, and the
search for water in space.
Engineering for our Oceans (2 hours)
Topics include: Understanding tides, properties of waves, harvesting water’s energy through dams and wave
energy, tsunamis damage and preparation.
*H2O Museum Scavenger Hunts are available upon request.
Engineering Design Workshops (45 Minutes to 1 Hour each program)
Engineering Tour & Engineering Design Challenge (Grades K-12)
Tsunami Structure Strength Engineering Challenge (Grades 4-12)
Water Filtration Challenge (Grades 4-12)
Feel the Heat NASA Challenge
Boy Scout Programs
Email education@sprucegoose.org for more program information:
Location: Air & Space Museums/ Wings & Waves Waterpark
Merit Badges
Aviation
Engineering
Robotics
Space Exploration
Weather
Cub Scout Workshops
Bear Aircraft Elective
Bear Swimming Elective
Bear Weather Elective
Webelos Science Pin
Astronomy Beltloop
Science Beltloop
Weather Beltloop
Camping
Night Flight/Evening at the Museum
Girl Scout Programs
Email education@sprucegoose.org for more program information:
Location: Air & Space Museums/ Wings & Waves Waterpark
Brownie Try-It Badges:
Earth and Sky
Movers
Science Wonders
Space Explorer
WOW – Wonders of Water Journey
Junior Girl Scout Badges:
Aerospace
Making it Matter
Science Discovery
500 NE Captain Michael King Smith Way McMinnville, OR 97128 Tel: 503.434.4185 Fax: 503.434.4188

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Sky Search
Weather Watch
Swimming
Water Fun
Camping
Night Flight/Evening at the Museum
Specialty Programs:
Call or email for more information about these programs: at (503)434.4185 or education@sprucegoose.org
Check program you are interested in:
Home-School Days
Night Flight/Evening at the Museum
Outreach Education
P.A.C.E. (Partnering for an Accessible Camp Experience (P.A.C.E. Camp) Engineering Challenge Programs: 1
week camp: 5 full or half days: During school year or summer option: Lessons for youth ages 9-17.
Summer Camps
500 NE Captain Michael King Smith Way McMinnville, OR 97128 Tel: 503.434.4185 Fax: 503.434.4188

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I hereby DO NOT give permission to Evergreen Aviation & Space Museum to use my name,
photographic likeness or story. By signing this exclusion, I DO NOT grant EASM a royalty-free,
world-wide, perpetual, non-exclusive license to display, distribute, reproduce or create derivative
works of the photograph/video, in whole or in part, in any media now existing or subsequently
developed, for any EASM purpose, including, but not limited to advertising and promotion of
Museum. NO Photographs/videos may appear on the EASM Web site, or in EASM publications.
EASM WILL be required to pay additional consideration or seek any approval in connection with
such uses. Please return this exclusion before the actual visit date.
Print Name:_______________________________________
Address:____________________________________________________________________________
___________________________________________________________________________________
E-mail:___________________________________________
Telephone:________________________________________
Signature:_________________________________________
Date:_____________________________________________
If participant is under 18: I, _______________________________, am the parent/legal guardian of
the individual named above, I have read this exclusion and approve of its terms.
Print Name _________________________________________
Address:____________________________________________________________________________
___________________________________________________________________________________
Telephone:_________________________________________
Parent Signature:____________________________________
Date: ______________________________________________
500 NE Captain Michael King Smith Way McMinnville, OR 97128 Tel: 503.434.4185 Fax: 503.434.4188