Curric-ZOO-lum: 3rd Grade Registration Form

Complete this form and return it AS SOON AS POSSIBLE to insure you will get your choice of dates. Please schedule at least two weeks in advance. Arrival time at the Zoo should be 10:00am. IF THIS IS NOT POSSIBLE, PLEASE INDICATE THE EARLIEST THAT YOU CAN ARRIVE.

Please note - We ask that the students be divided into 3 equal groups if you have 60 or more students. If you have less than 60 students, please divide them into 2 equal groups. The teachers and chaperones (one adult per every 8 students / 5 additional chaperones max) should be equally distributed among the groups. The students and chaperones should know before they arrive if they are in “Group 1”, “Group 2” or “Group 3”.

*Required field

*School:
*County:
*Address:
*City:
*Zip:
*Contact Person:
*Phone:
*Email:
*Grade Level / Program:
Total # of 3rd Grade Classes:
First Program Date:
...Alternate Date:
1st Visit - # of Teachers:
1st Visit - # of Classes:
1st Visit - Approx. # of Students
1st Visit - # of Chaperones (at least 1 per 8 students - 5 additional chaperones max):
Second Program Date:
...Alternate Date:
2nd Visit - # of Teachers:
2nd Visit - # of Classes:
2nd Visit - Approx. # of Students:
2nd Visit - # of Chaperones:
Third Program Date (if applicable):
...Alternate Date (if applicable):
3rd Visit - # of Teachers:
3rd Visit - # of Classes:
3rd Visit - Approx. # of Students:
3rd Visit - # of Chaperones:
Please note any special requirements, such as wheelchair needs:
Please answer the simple math question below to submit the form.
2 + 2 =