Online Field Trip Request

Online Field Trip Request
First choice

Month Day Year
2nd choice

Month Day Year
Please provide an alternate date if you can
Field trip choice *

Work & Play (2 hours) minimum 15 students Heritage Classroom (4 hours) Minimum 15 students, Max. 32
How many students in your group?
Grade
Arrival time

: Hour Minutes AM/PM Option
Departure time

: Hour Minutes AM/PM Option
Will you need time for lunch?

Yes No
Teachers name

First Name Last Name
Contact number (cell is best)

Area Code Phone Number
E-mail
School/ organizations Name
Address

Address

Address 2

City State

Zip Code
What is the best way to contact you?

Phone Email Either
Anything else we should know?
Thank you for chosing Lyles Station as your field trip destination.

We will be in contact to confirm your reservation.
Should be Empty: