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2. 
3. 
5. Contact Person Full Name: *
   Please put full name using to create an account here.
6. Email
7. Phone Number
9. Create An Account
   Create an Online Account Here

   Please click on the registration link above to create an online account with your personal information. This creates a personal account for you with JCPRD and will be linked to the School account I create with the information you provided in this form. By creating a personal account I can link you as an online administrator for the School to view their account online. Do not create an account for yourself and the school.
11. School Name*
    Please put N/A if it doesn't apply
12. School Address*
14. School City*
15. School Zip Code*
16. School State*
17. School Phone Number*
19. School District*

    1. Blue Valley School District
    2. De Soto School District
    3. Olathe School District
    4. Shawnee Mission School District
    5. Other
20. What grade are your students? *
21. How many students do you have? *
    Groups over 100 people will need to book on a Tuesday, Wednesday or Thursday.
23. Date #1
    Date #1
    This date is your first choice for a field trip.
24. Date #2
    Date #2
    This date is your second choice for a field trip.
25. Date #3
    Date #3
    This date is your third choice for a field trip.
28. Date #4
    Date #4 Start Date

    —

    Date #4 End Date
    If you are wanting two dates you can input two here or use the notes section.
29. Day of the Week

    If you don't need a specific date, but prefer a certain day of the week, tell us what day's work in your schedule.

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday
    5. Friday
    6. Saturday
31. Type of Field Trip Requesting*

    1. Low Challenge Course (9am-2pm)
    2. Low and High Challenge Course (9am-3pm)
    3. Activity Day with 4 rotations (up to 60 students)
    4. Activity Day with 5 rotations (up to 75 students)
    5. 2 day program - Low Challenge Course/Activity Day
    6. Need additional options
32. How did you hear about our field trips? *

    1. TimberRidge Website
    2. Johnson County Park and Recreation Website
    3. Another Teacher
    4. Friend or Family Referral
    5. Facebook - TImberRidge Page
34. Additional Information to share
    Add any notes or additional information we may need to schedule your group. If you want a second field trip scheduled, note here with two date choices.
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field