EDUCATION

Group Distancing Programs Reservation Form

Attendees & Program Options

Program(s)

Program Option

Please select the maximum number of students that might attend. We understand that these numbers are subject to change.

Group & Contact Information

Organization Name *

Type of Organization

Primary Contact Name *

First

Last

Primary Contact Email *

Primary Contact Phone *

Secondary Contact Name *

First

Last

Secondary Contact Phone

Organization Address

Address Line 1

Address Line 2

City

State

Zip Code

Organization Phone

Does your group include underserved communities? Please review the following options and select ALL THAT APPLY to your group.

This is optional, but your selections are used to better develop our programming. Disclaimer: this data is only for Fossil Rim Wildlife Center's records.

Has your organization ever been to Fossil Rim?

Yes
No

Did your organization participate in an education program?

Yes
No

How did you find out about Fossil Rim?

Dates & Special Instructions

Preferred Date

Please select the date your group would prefer to visit with Fossil Rim. Please note this is a request and that dates are not actually reserved until availability is confirmed and deposit is received.

Alternative Date

Please select an alternative date in the event your preferred date is unavailable.

Any Additional Notes

Name

USA TODAY Top Wildlife Park

EDUCATION

Attendees & Program Options

Group & Contact Information

Dates & Special Instructions