Group Pre-registration Form

Please include as much information as possible when completing the following form.

After submitting the form below, you should be redirected to a confirmation page. If you are taken back to the top of this page, your form was not submitted correctly; please contact Josh Gross at 304-561-3562 or jgross@theclaycenter.org.

Group or School Name

Contact Person

County

School Address

City, State, Zip

Work/School Phone

Alternate Phone Number

Best time to call

Perferred contact:

Fax

Email

Grade Level(s): (Check all that apply)














Number of students:

Number of chaperones: (1 for every 10 students)

Number of additional adults:

Due to limited availablility of certain programs, please indicate three dates your group would be interested in attending. Date you wish to visit:
1st Choice:

2nd Choice:

3rd Choice:

Arrival Time: (earliest)

Departure Time: (latest)

Note: We allow 30 minutes for check-in.
Programs you wish to include:







Lunch: (30 minutes)



For menu information and/or to pre-order, call 304-561-3580 or email cafe@theclaycenter.org.
Transportation:



Method of payment:



Is the group tax-exempt?

Access Fund:

Special Needs: (Please indicate how many and provisions needed)

Hearing Impaired

Sight Impaired

Wheelchair accessible seating

Other