Primary Contact (Person responsible for organizing the field trip) *

First Name

Last Name

Phone *

(###)

###

####

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Field Trip Location *

Doolittle County Park and Gales Pond

Otto Nature Preserve

Other

Field Trip Date *

Contact Educator Kari Wilson to arrange date and time for your field trip.

MM

DD

YYYY

Start time for the 1.5 hour program *

Hour

Minute

Second

AM PM

Payment *

A minimum booking of $100 with a $50 deposit is required to schedule a field trip.

I will make an on-line payment of the $50 deposit now and bring the balance due on day of programming

I will make an on-line payment of total program fees of $100 now (group size 20 or fewer.)

I will call the office to make payment arrangements