Science in the Park School Field Trip Registration

Our Science in the Park instructors lead fun, hands on programs for grades K-6
that reinforce 2018’s Standards of Learning (SOL’s).

Please join us as we use our forests, lakes, streams, and fields to support what’s being taught in the classroom. We look forward to seeing you in one of our parks soon!

Lake Ridge Park • Locust Shade Park • Silver Lake Regional Park

For information, contact: SIP@pwcgov.org

Important Information: (please fill out)

1. Grade Level *This question is required.

2. Date(s) of Field Trip *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Program Time: 10:00 am to 12:30 pm
Bring your own lunch: 12:30pm to 1:00pm

3. Please indicate the park you are requesting to visit for your field trip: *This question is required.

4. School Name *This question is required.

5. School Phone Number *This question is required.

6. School Address *This question is required.

7. Estimated # Students Attending per Day ($10.00 per student)

*An estimated number of students is expected 5 days before your field trip date. You will be invoiced after the program for the number of students in attendance or your estimated number minus 10%, whichever is greater. Teachers and chaperons are free. Day-of cancellation, excluding weather, subject to administrative fee. *This question is required.

School Contacts:

8. Lead Teacher Name *This question is required.

9. Lead Teacher's Email Address *This question is required. This question requires a valid email address.

10. Lead Teacher's Cell Phone Number (for day-of communication) *This question is required.

11. Bookkeeper Name *This question is required.

12. Bookkeeper's Phone Number *This question is required.

13. Bookkeeper's E-mail Address *This question is required. This question requires a valid email address.

14. Principal's Name *This question is required.

15. Principal's Phone Number *This question is required.

16. Principal's E-mail Address *This question is required. This question requires a valid email address.

17. Special Accommodations *This question is required.

18. Environmental Allergies

*Chaperone support required*

19. Please pick any 3 lessons (selections can be current grade or other):

*MWEE: Meaningful Watershed Educational Experience

To request reasonable ADA accommodations, please call 703-792-8066 *This question is required.