Cosmic Club Interest Form

Thank you for your interest in Cosmic Club! Please complete the following form and we will get back to you shortly.

Name

Organization / School Name

Location

Where is your organization or school located? *Please note that Cosmic Club is only available for Colorado locations at this time*

Contact Name

Contact Title

Contact Email

Contact Phone Number

Estimated Booking Date

What date/time are you interested in the program?

GMT

Age Level

# of Participants

How many students/youth will participate? (Note that sessions are generally for 25 kids at a time due to supervision needs)

Additional Notes

Tell us a little bit about your program and what you are looking for.

Inquiry Status

Select "Inquired" so your request can be reviewed in a timely manner.

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