Sign Up for an Elementary Program Field Trip

This sign-up form is for classes participating in the Splash Elementary Program. All others should visit the public programs section for information about public tours of the vernal pools.

If you received an invitation to schedule a field trip, please take a look the Field Trip Calendar 2011-12.  Select two available dates (a first choice and a second choice) and then submit this form. Splash staff will contact you within the next two business days to confirm your reservation.

Name: *

School: *

# of classes: * select...onetwo

1st choice date: *

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Year2012

2nd choice date: *

MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day12345678910111213141516171819202122232425262728293031

Year2012

Email for confirmation: *

2nd Teacher's Name (if two classes):

Comments?:

Please type these numbers into the box to verify that you are not a machine.: * 91468964453540 »