Disney Youth Education Series at Disneyland Resort in California
 
2012 Program Request Form
Fill Out All Appropriate Fields And Click "Submit" OR Click Here To Download A Printable PDF.
Only one application per group.
 
*  Indicates a Required Field
1. Group Leader Information
 
School or Organization Name *  
↑ Required ↑
Teacher or Group Leader Name *  
↑ Required ↑
 
Grade Level *  
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Age Range *  
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Mailing Address (No PO Boxes please) *  
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City *  
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State / Providence *  
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Postal Code *  
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Country *  
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Work Telephone *  
(with area code) ↑ Required ↑
Alt / Cell Telephone *  
(with area code) ↑ Required ↑
 
Fax *  
(with area code) ↑ Required ↑
E-mail Address *  
↑ Required ↑ ↑ Invalid email format ↑
 
2. Group Information
 
Anaheim Arrival Date & Time *  
↑ Required ↑
Anaheim Departure Date & Time *  
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Total Students *  
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Total Teachers *  
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Total Chaperones *  
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Total Additional Guests *  
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Note: Groups of 60 or more may be divided into different program times.
 
Teacher Information (please provide the name of each teacher participating in the program and the number of students in his/her class)
 
Teacher’s Name *  
↑ Required ↑
Number of Students *  
↑ Required ↑
 
Teacher’s Name  
Number of Students  
 
Teacher’s Name  
Number of Students  
 
3. Program & Date Selections
 
California Here I Come! - Early Morning †
at Disney California Adventure™ Park
Grades 3-5
Ages 8-11		 Disney’s World of Physics:
Energy and Waves
at Disneyland® Park
Grades 3-5
Ages 8-11		 Disney Leadership in Action:
Pursuit of Excellence
at Disneyland® Park
Grades 6-12
Ages 11-18
California Here I Come!
at Disney California Adventure™ Park
Grades 3-5
Ages 8-11		 Disney’s World of Physics:
Energy and Waves
at Disney California Adventure™ Park
Grades 6-12
Ages 11-18		  
Disney’s Animation Magic
at Disney California Adventure™ Park
Grades 3-12
Ages 8-18		 Disney’s World of Physics:
Properties of Motion
at Disney California Adventure™ Park
Grades 6-12
Ages 11-18		  
† California Here I Come! - Early Morning program begins between 7:45 a.m. - 9:15 a.m. and includes Golden Derams.
California Here I Come! program begins after park opening and includes Mission Tortilla Factory or Boudin Bakery.
All programs subject to availability. Program content, times, attractions, and locations subject to change due to inclement weather, availability or group dynamics. A Disney Youth Group Ticket is required for participation. Students must meet minimum age/grade requirements.
 
Program Date Preference 1 *  
(2012 dates only)
↑ Required ↑
Program Date Preference 2 *  
(2012 dates only)
↑ Required ↑
 
Disney Youth Education Series programs are available 7 days a week with the exception of December 21 - 31, 2012.
 
  YES, I am interested in being contacted by a Disneyland representative regarding dining options and/or hotel accommodations for my group.
 
Special Request / Needs (including experience times)
 
4. Ticket Package (Please indicate the ticket package that you intend to purchase. A ticket order form will be mailed to you once your program and date have been confirmed.)
  Disney Youth Education Series Program Only Ticket
Includes admission for only the length of the Disney Youth Education Series program at Disneyland® Park or Disney California Adventure™ Park.
Regular Price: $34.00
  1-Day Ticket to Disneyland® Park or Disney California Adventure™ Park.
Includes the Disney Youth Education Series program plus same-day admission to Disneyland® Park or Disney California Adventure™ Park.
Regular Price: $66.00   Value Price: $59.00
  1-Day Park Hopper® Ticket
Includes the Disney Youth Education Series program plus same-day admission to Disneyland® Park and Disney California Adventure™ Park.
Regular Price: $76.00   Value Price: $69.00
  2-Day Park Hopper® Ticket
Includes the Disney Youth Education Series program, same-day admission to Disneyland® Park and Disney California Adventure™ Park plus one (1) additional park admission. Ticket includes entry to both parks on the same day. Ticket expires 13 days after first use, and each day the ticket is used constitutes one full day.
Regular Price: $119.00
  3-Day Park Hopper® Ticket
Includes two (2) Disney Youth Education Series programs, same-day admission to Disneyland® Park and Disney California Adventure™ Park plus two (2) additional park admissions. Ticket includes entry to both parks on the same day. Ticket expires 13 days after first use, and each day the ticket is used constitutes one full day.
Regular Price: $135.00
  4-Day Park Hopper® Ticket
Includes two (2) Disney Youth Education Series programs, same-day admission to Disneyland® Park and Disney California Adventure™ Park plus three (3) additional park admissions. Ticket includes entry to both parks on the same day. Ticket expires 13 days after first use, and each day the ticket is used constitutes one full day.
Regular Price: $148.00
  5-Day Park Hopper® Ticket
Includes two (2) Disney Youth Education Series programs, same-day admission to Disneyland® Park and Disney California Adventure™ Park plus four (4) additional park admissions. Ticket includes entry to both parks on the same day. Ticket expires 13 days after first use, and each day the ticket is used constitutes one full day.
Regular Price: $156.00
  Disney Youth Education Series Additional Program Upgrade
Add another Disney Youth Education Series program to your visit with the purchase of a Disney Youth Education Series 1-Day or multi-day ticket.
Regular Price: $15.00

Prices are valid January 1 – December 20, 2012. Please refer to the Disneyland Youth Education Series Value Day Calendar to see select dates in which Value Pricing is available. All Disney Youth Education Series tickets are blocked out December 21-31, 2012.

One complimentary chaperone ticket will be issued for every 10 paid students. One complimentary teacher ticket will be issued for every 30 paid students. Tickets for additional guests include park admission only.
Additional guests will not be permitted to accompany the group on the Disney Youth Education Series program.
↑ Please Select a Ticket Package ↑
 
Travel Planner Information
(Optional)
 
Travel Agency  
Contact Name  
 
Address (No PO Boxes please)  
City  
 
State / Providence  
Postal Code  
Country  
 
Telephone  
(with area code)
Fax  
(with area code)
 
Email Address  
↑ Invalid email format ↑
 
What’s Next
 
Once your information has been received and processed, you will receive the following communication from Disney Youth Education Series:
  - Confirmation letter stating your group has been booked.
  - Itinerary including the date(s) of your visit. Program times will be available approximately three (3) weeks prior to your program date(s).
  - Detailed information to assist you in planning your Disneyland Resort visit.

Please contact us immediately at 800-854-8671 or e-mail dl.youth.education.series@disney.com if your group numbers change or if a conflict arises regarding your travel date(s).
 
I have read and understand the application procedures *
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Signature *  
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Your Email Address *  
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