Registration Form

Reserve using the form below, or call the OMSH OnTheMove office at the Owensboro Museum of Science and History at (270) 687-2732 or use the Contact Form for more information. Fields marked * are required.

Agriculture Adventures: KENTUCKY Reservation Request

Name *

First

Last

Position *

School/Event Organization *

Address #1 *

Address #2 *

City, State, Zip *

Contact Name (if different from above) *

First

Last

Phone Number *

Alternate Phone Number *

Email *

Have You Hosted an Agriculture Adventure: KENTUCKY program in the past? *

Number of Days Requested? (500 student capacity per day) *

Number of Participants? (Total for all requested days) *

What date is your FIRST choice to host Agriculture Adventures: KENTUCKY? *

Impossible Days? (Breaks during school year, etc.) *

How did you hear about this program? *

Additional notes or questions? *

You will receive an email within 72 hours confirming only that we received your reservation request - not that your reservation has been made.
If you do not receive this confirmation, please call (270) 687-2732