Educational Program/Field Trip Request
Requests should be made a minimum of one week prior to requested date. Participation is based on staff availability.
Name of School
*
School District
*
Contact Person
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Grade/age
*
Total number of students
*
Number of sections/classes?
*
Program topic or field trip theme
*
Have you done this field trip/program in the past?
*
Yes
No
Other
Location
*
Classroom
Field trip
Other
Field trip location
Jester Park
Easter Lake Park
Thomas Mitchell Park
Chichaqua Bottoms Greenbelt
Fort Des Moines Park
Other
Do any students/staff need the following accommodations?
Universal changing table
Wellness room (quiet/lactation space)
Accessible trails
Other
1st choice
*
-
Month
-
Day
Year
Date
2nd choice
*
-
Month
-
Day
Year
Date
3rd choice
-
Month
-
Day
Year
Date
Field trip arrival time
*
Hour Minutes
AM
PM
AM/PM Option
Field trip departure time
*
Hour Minutes
AM
PM
AM/PM Option
Available times
*
Submit
Should be Empty: