Field Trip Request Form
PLEASE ONLY SUBMIT ONE FORM
School Name
*
First Name
Last Name
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organizer's Name
*
First Name
Last Name
Organizer Cell Phone Number
*
Format: (000) 000-0000.
Organizer E-mail
*
example@example.com
Is this your first field trip to 4D Farm?
*
Please Selecti
Yes
No
Estimated Number of Students
*
Grade
*
Will you allow siblings to attend field trip?
*
Please provide your top 2-3 preferred dates to visit the farm. We will always choose first date listed, if available.
*
Preferred Arrival Time?
*
9:00
9:15
9:30
9:45
Choose Your Field Trip Preference (Must have 15 or more students to select the first two options.
*
$12.00 Pumpkin Picking Field Trip
$17.00 Pumpkin Picking PLUS Gem Mining
ADD ON: Please add animal feed for each student $2.00
Field Trip with less than 15 students and will be paying $14.95 online or $15.95 at the gate the morning of field trip.
How will you be arriving to 4D Farm?
*
Please Select
We will be arriving by car.
We will be arriving by bus.
I understand that all scheduled students will be paid in one transaction by the field trip organizer. All siblings and parents will purchase tickets online or at the gate.
*
YES
Submit
Should be Empty: