Crossroads Field Trip Request Form

Field Trip Inquiry

Your Name(Required)

First Last

Your Email Address(Required)

Email Address Confirm Email Address

Your Phone(Required)

Group / School Name(Required)

Dates / Times Requested(Required)

Number of Students(Required)

Feel free to estimate.

Ages / Grade Level(s)(Required)

Number of Adults / Chaperones(Required)

Specific Theme or Topic and Activity

Do you need to meet state standards?

Yes

If yes, which state standards?

Please note any allergies or medical needs.

What is your method of transportation?

(e.g., bus, van, walking, car)

Emergency Contact During Trip

First Last

Phone

Please specify any required special equipment or supplies needed.

Meal Plans

If you are planning lunch at Crossroads at Big Creek.

Please share any other comments here if you'd like.