Magic Springs Water and Theme Park 1701 East Grand Ave, Hot Springs, AR 71901 Office: 501-318-5370 Fax: 501-318-5367 2016 Education in Motion Ticket Order Form Please fill out form including signature at the bottom and return to your Group Event Planner no later than 5 business days prior to your visit. EIM Dates to choose from include: May 6, 13, or 20 School Name: Customer No: Contact Name: School Fax: Phone: Cell: E-mail: Representative: April Ayers Address: Rep's Phone: 501-318-5310 City/State/Zip: Rep's Fax: 501-318-5367 Date of Visit: May Rep's email: aprilp@magicsprings.com Ticket Type Quantity Education in Motion Admission Buffet Meal Reservation No: Ticket Price Breakdown $17.93 $2.06 tax $19.99 $8.67 $1.08 tax $9.75 Complimentary Chaperone (One given per 15 purchased tickets) Total Total 0.00 0.00 0.00 0.00 The terms and conditions of this agreement are as follows: 1. Total amount of admission tickets purchased must equal 10 or more to qualify for group rates listed above. 2. One complimentary chaperone ticket will be given for each 15 admission tickets that are PURCHASED. 3. Only one form of payment will be accepted at the ticket window. Tickets may not be purchased separately. 4. If using a Purchase Order, it must be received at time of booking to reserve tickets. Purchase Order must include ticket price, total cost, number of tickets, and signature from responsible party, to be valid. 5. Bus Drivers receive Complimentary admission on EIM days when they present their Commercial Driver's License at the ticket window. Complimentary ticket does not include a meal, but you may purchase one for them. Representative of Group (Signature) Rep of Magic Springs (Signature) April Ayers Printed Name Printed Name Title/Date Approval/Date