Camp Leopold Field Trip Request
Contact Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
School Name and District:
*
Which programing are you interested in:
*
Single Day
2- Day Overnight
3- Day Overnight
Leopold PLUS+
(If you chose our PLUS+ program: Would you like Camp Leopold to attend your school more than once?
Yes
No
Possible Start Date: (Option 1)
*
-
Month
-
Day
Year
Date
Approve Date 1?
Please Select
Yes
No
Possible Start Date: (Option 2)
*
-
Month
-
Day
Year
Date
Approve Date 2?
Please Select
Yes
No
Possible Start Date: (Option 3)
*
-
Month
-
Day
Year
Date
Approve Date 3?
Please Select
Yes
No
Maximum Number of Students That Would Attend:
Grade of Students:
*
Pre K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Submit
Should be Empty: