| Name of School / Group: |
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| Street Address: |
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| City, State, Zip: |
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| School Phone Number: |
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| School Fax Number: |
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| Contact Person: |
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| Contact Person's Cell Number: |
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| Contact Person's Email Address: |
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| Age / Grade of Children: |
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| Number of Children: |
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| Number of Classes: |
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| Reservation for one hour Field Trip @ $3.50 |
| Reservation for two hour Field Trip @ $5.50 |
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| Will your group be eating lunch at the farm? |
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| Departure Time from School: |
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| Arrival Time at Farm: |
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| Date and Day of First Choice: |
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| Date and Day of Second Choice: |
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