15479 Clayton Road
Ballwin, MO 63011
Tel:  (636) 207-7405
Fax: (636) 207-7407

Group Visit Registration
(please fill out, print and mail to Worldways)

We are delighted that you are planning to visit Worldways Children's Museum.
Please complete this form, print it and mail it back to us along with your payment for $____.
This total includes a deposit and a $5.00 non-refundable booking fee. See deposit scale below.

 

Name of group: Date of visit:

Person(s) in charge:

Scheduled arrival time: Scheduled departure time:

Work phone: Home phone:

Address:

City: State: Zip Code:

E-mail address:

Number of children: Adults: Ages/Grades:
Special needs, please specify:

Form of payment: (please make checks payable to Worldways Children's Museum)

Credit card number: ________________________(for safety reasons please handwrite the card #)

Expiration date:______/______Your signature : ________________________

Deposit price based on your group size: (please select one)