2020/2021 TimberRidge Adventure Center Field Trip Request Form

2. 

3. 

5. School Name*

   Please put N/A if it doesn't apply

6. Have you brought a group to TimberRidge before?

   1. Yes
   2. No

8. First Name*

9. Last Name*

11. Address*

    Fill out if this is the first time your school is booking a program with TimberRidge

13. City*

    Fill out if this is the first time your school is booking a program with TimberRidge

14. Zip Code*

    Fill out if this is the first time your school is booking a program with TimberRidge

15. State*

    Fill out if this is the first time your school is booking a program with TimberRidge

17. Phone Number*

18. Email Address*

20. School District*

    1. Blue Valley School District
    2. DeSoto School District
    3. Olathe School District
    4. Shawnee Mission School District
    5. Other

21. What grade are your students? *

22. How many students do you have? *

    Groups over 100 people will need to book on a Tuesday, Wednesday or Thursday.

24. Blue Valley Dates to Consider

    1. No School - 09/18
    2. No School -10/1 or 10/2
    3. Early Dismisal - 10/14
    4. No School - 10/16
    5. No School - 10/19
26. DeSoto Dates to Consider

    1. Early Dismissal - 09/30
    2. No School - 10/1 & 10/2
    3. No School - 10/16
    4. No School - 10/19

28. Olathe Dates to Consider

    1. No School - 09/25
    2. No School - 10/09
    3. Early Dismissal - 10/14
    4. No School - 10/15 & 10/16

30. Shawnee Mission Dates to Consider

    1. No School - 09/18
    2. No School - 10/16
    3. No School - 10/23

32. Date #1
    Date #1

    This date is your first choice for a field trip.

33. Date #2
    Date #2

    This date is your second choice for a field trip.

34. Date #3
    Date #3

    This date is your third choice for a field trip.

37. 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.

38. 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
40. 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
41. 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
43. 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:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit Submit and Print

* indicates a required field