KCSC Road Trippers Registration Form

KCSC Road Trippers' Registration Form

Please fill out the below form to register for our upcoming road trip! This program is for older adults who want to go places with likeminded and similarly aged people. The KCSC Road Trippers' will offer regional day trip travel experiences designed with lifelong learners in mind — those who want to learn about our destinations and experience new adventures in a group setting.
On Ocotber 24, 2024, we will meet at 8 am at the offices of the KC Shepherd's Center at 9200 Ward Parkway, KCMO 64114 to board the bus to Louisberg, Kansas. Our first stop will be the Cedar Cove Feline Conservation Park. After that we will head over the Miss Bee's Cafe for a Fried Chicken lunch. From there we will head to the Louisberg Cider Mill to spend the rest of the afternoon while treating ourselves to apple cider and donuts. We intend on arriving back at the KC Shepherd's Center offices around 5 pm.

Seating is limited to 20. Registration deadline is October 18th.

The cost per person for this trip is $45. You can pay online. You will be redirected to the online donation page after you complete this form.

**Please put in the NOTES section: ROAD TRIPPERS.

OR you can write a check and mail it to our offices at the address below.

**Please put ROAD TRIP in the memo line.

KC Shepherd's Center

9200 Ward Parkway

Suite 200

Kansas City, MO 64114
Excursion to Louisberg, Kansas

October 24, 2024
Name of Traveler (Please fill out a form for each traveler separately):*

First NameLast Name
Are You Traveling Alone or With Someone?
If Traveling With Someone, Please Provide Their Name Here:
Phone Number*
Please enter a valid phone number.
Phone Type*

CellHomeWork
Email:
example@example.com
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Person:*

First NameLast Name
Emergency Contact Phone Number:*
Please enter a valid phone number.
Please describe any medical concerns, disabilities or dietary choices (gluten, allergies, vegan) that you wish to share or questions about the food options:
Thank you for registering! Please leave any comments or questions you may have below.
Should be Empty:

KCSC Road Trippers' Registration Form

Excursion to Louisberg, Kansas