Youth Intake Form

Field Trip Interest Form

For K-12 School and College Groups
Thank you for your interest in a Field Trip to the Muhammad Ali Center. Once you have submitted this form a Muhammad Ali Center representative will respond within 3 business days. Please note that all group tours are scheduled at least 3 weeks in advance to ensure staffing and availability. Field Trips are available Wednesday-Sunday, 10:00 AM - 5:00 PM.
Contact Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
School/Organization:*
Title I School?*

YesNo
E-mail:*
School Phone Number:*

Area CodePhone Number
Contact Cell Phone Number:*

Area CodePhone Number
Field Trips are available Wednesday-Sunday, 10:00 AM - 5:00 PM. Field trips will be scheduled for 2 hour blocks unless otherwise noted. After-hours tours are available for additional fee and are subject to availability. Tours must be requested at least 3 weeks in advance of your tour date.
Requested Visit Date 1:*

MonthDayYear
Requested Visit Date 2:*

MonthDayYear
Requested Arrival Time (EST):*

:HourMinutesAM/PM Option
# Buses or Vans: *
Grade Level of Group Participants*

K-23-56-89-12College
Number of Students*
Number of Chaperones (1 free per 6 students):*
Type of Tour (Please Select Only One) :*

Self Guided Tour ($8/student)Guided Curriculum Tour ($10/student; not available on Sundays)After Hours Tour (after 5pm, additional fees apply)College ($10/Participant)
Guided Curriculum Option (Select Only If You Chose Guided Curriculum Tour Type Option Above; Not available on Sundays)

Civil Rights"City of Ali" Field Trip and Film ScreeningMuhammad Ali's 6 Core Principles (Respect, Giving, Spirituality, Dedication, Confidence, and Conviction)
Special Needs or Disabilities:
Does your group wish to visit the Muhammad Ali Center retail store?*

YesNo
Method of Payment:*

CashDebit/Credit CardCheckSchool Purchase Order
Time of Payment*

Prior to visitUpon arrival
How did you hear about the Ali Center?
I understand that submitting this form does not constitute a group tour reservation.*
Date*

MonthDayYear
You will receive an email confirmation once you submit this form. Please allow three business days for a response.
Should be Empty:

Field Trip Interest Form

Field Trips are available Wednesday-Sunday, 10:00 AM - 5:00 PM. Field trips will be scheduled for 2 hour blocks unless otherwise noted. After-hours tours are available for additional fee and are subject to availability. Tours must be requested at least 3 weeks in advance of your tour date.