A separate form is needed for every requested tour. If you are requesting multiple tours, please submit a separate form for each tour.

Contact Information

Group/School Name *

Contact Name *

Address

City

State

Zip Code

Address Type *

Residence

Business

Work Phone

FAX

Home Phone

Additional Phone

Email Address

Preferred Method of Contact

Group Size

Group Type

#1 Preferred Date and Time

#2 Preferred Date and Time

#3 Preferred Date and Time

Air George

Would you like a tour of Air George, the Hospital’s emergency transport helicopter and heliport? (Adds 30 minutes to tour)

Yes

Lunch Information

Will your group be staying for lunch in the Grape Jellyfish Café? *

Yes

If yes, will you be preorder lunch or will you go through our café line?

Café Line

Box Lunch ($5.33) includes sandwich, chips, fruit, cookie and soda

Pizza ($4.15) includes pizza chips and soda