LASM 2013 Summer Reservation Form
1. Complete the summer reservation form with your information and press the SEND button.
2. Please complete a separate form for each visit.
3. *Items marked with a red asterisk are required.
4. After we receive your form, you will receive a confirmation stating the date, time, schedule, cost per person, and deposit information. Please allow up to three business days to receive your confirmation.
5. Your reservation is NOT final until you fax a SIGNED copy of your confirmation to LASM at 225-214-1445.
*Group Name  
*Zip Code  
* Phone Number  
Fax Number  
*Contact Person  
*Contact's E-mail  
*Number of Children *Age Range to
*Number of Chaperones/Adults  
I have children with special needs   Yes    No  
  If yes, please let us know what special accommodations we should make:
DATE OF VISIT (Note, LASM is closed on Mondays)
*First Date Choice    (mm/dd/yyyy)
*Second Date Choice    (mm/dd/yyyy)
*Arrival Time  
*Departure Time  
How would you like to receive your confirmation?   Fax    Email   Mail
If you are unable to take advantage of your scheduled visit to The Museum Store at LASM, please comment:
Planetarium Shows  
Auditorium Interactive Programs  
Auditorium Films
Museum Gallery Add-ons
$0.50/person per gallery
Museum Gallery Add-ons are available for $.50 per child and chaperone for each Gallery. Please select from the following:
Ancient Egyptian Gallery
Art Gallery (closed July 15-19)
Discovery Depot
Science Station
Solar System Gallery
Additional Comments 

We recommend that you print this page before clicking the SEND button.