Game Night at the Museum
Registration Form
Friday, January 20th from 6pm - 9pm at the Sternberg Museum
Spend an evening exploring the Museum and playing natural science games for all ages.
Snacks and drinks will be provided during our activities.
Ages 5 and up.
Children under 8 must be accompanied by an adult.
Register no later than the Wednesday of the same week (registration required)
$10 for museum members - $13 for general public, Limit 15 children
Date Attending: _____________________________________________________
Child’s name (please print)_______________________________________________Age___________
Parent’s name (please print) _____________________________________________________________
Address & City _______________________________________________________________________
Allergies ____________________________________________________________________________
Special Needs ________________________________________________________________________
Email Address _______________________________________________________________________
Parent phone: (home) __________________ (cell) _________________ (work) ___________________
Emergency Contact (if parent not available)
Name ________________________ Phone Number(s) _______________________________________
I give permission for my child to attend the evening programs and will allow medical treatment to be
given if necessary. Parent Signature_____________________________________Date_____________
I give the Sternberg Museum permission to use my child’s picture in the museum’s publications,
advertisements or website. Parent Signature_________________________________Date___________
The Sternberg Museum of Natural History is not responsible for any accidents.
Please send registration along with payment to:
Sternberg Museum of Natural History
Attn: Education Department
3000 Sternberg Drive
Hays, KS 67601
Checks payable to:
Sternberg Museum of Natural History
Friday Night at the Museum
Thank you