School Group Reservation 2021-2022 Reservation Form

Contact Information

Teacher's Name*

School Name*

School District*

County*

Type of School*

We are a Title 1 School*

Yes
No

Grade Level*

School Address*

Street Address City State ZIP Code

School Phone*

School Fax

Teacher's Email*

Teacher's Mobile Phone

Preferred method of contact?

Email
Phone

Don't Let the Pigeon Drive the Bus (9/21/21 - 10/22/21)

Please choose your 1st and 2nd date/time options

Date (1st choice)*

Time (1st choice)*

Date (2nd choice)*

Time (2nd choice)*

# Student Tickets

# Adult Tickets

A Little House Christmas (11/3/21 - 12/17/21)

Please choose your 1st and 2nd date/time options

Date (1st choice)*

Time (1st choice)*

Date (2nd choice)*

Time (2nd choice)*

# Student Tickets

# Adult Tickets

The Watsons Go to Birmingham - 1963 (1/19/22 - 2/11/22)

Please choose your 1st and 2nd date/time options

Date (1st choice)*

Time (1st choice)*

Date (2nd choice)*

Time (2nd choice)*

# Student Tickets

# Adult Tickets

Pete the Cat (2/22/22 - 4/1/22)

Please choose your 1st and 2nd date/time options

Date (1st choice)*

Time (1st choice)*

Date (2nd choice)*

Time (2nd choice)*

# Student Tickets

# Adult Tickets

Dragons Love Tacos (3/15/22 - 3/18/22)

One show time available: 10:30am, please choose 1st and 2nd date options.

Date (1st choice)*

Date (2nd choice)*

# Student Tickets

# Adult Tickets

Charlotte's Web (4/12/22 - 5/13/22)

Please choose your 1st and 2nd date/time options

Date (1st choice)*

Time (1st choice)*

Date (2nd choice)*

Time (2nd choice)*

# Student Tickets

# Adult Tickets

Other Information

Confirmation*

I have selected both 1st choice date and time for each performance of my reservation inquiry.

Comments/Dates you cannot attend:

Are you receiving funding for this field trip from Arts Connect?*

Yes
No

Do you have students who require wheelchair seating?*

Yes
No

If yes, how many?*

Do you have any hearing-impaired students?*

Yes
No

If yes, how many?*

Do you have any students who have low or no vision?*

Yes
No

If yes, how many?*

You've answered "yes" to one or more of the questions above.

Our Accommodations Facilitator will contact you to coordinate assistance.

Demographic Requirements

Our funders require that we provide them with the following information. In order to continue to keep our ticket prices low, we hope you will help us by providing the information. Thank you so much.

To the best of your ability, please give the actual numbers of students in your classes who are attending the field trip to Main Street Theater:

African American

Asian American/ Pacific Islander

Caucasian

Latino/Hispanic

Native American

Multi-racial

People with disabilities

Agreement

Confirmation required*

I have read and understand the Ticket Policies that govern all student matinee group sales. I further understand that submission of this inquiry form is not a guarantee of a reservation.
I understand that children under the age of 3 (including sleeping babies) are not allowed in the theater.

A member of our staff will contact you about your request within 48 hours.

If you are not contacted in that time or have any questions regarding this order, please call 713-524-9196.

Comments

This field is for validation purposes and should be left unchanged.