SCHOOL TOUR RESERVATION REQUEST FORM
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( * = required information )
* School Name
* School Address 1
School Address 2
* City
* State
* ZipCode
* Contact Name
* Contact Phone
* E-mail Address
* Teacher's Name
* Grade(s) Attending
(examples: 5th, or 2nd-4th, etc)
* Estimated Student Count
* Estimated Teacher Count
* Estimated Adult Count
* Which Tour
Select Tour
Carolyns Country Cousins Pumpkin Patch
Uncle Earls Mining Camp
Liberty Corn Maze
* Staying for Lunch ?
Yes
No
* Little Bud's Railroad reservation ?
Yes
No
* 1st Reservation Date Choice
Month (Season)
September (Fall)
October (Fall)
November (Holiday)
December (Holiday)
March (Spring)
April (Spring)
May(Spring)
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Time
9:00am
9:15am
9:30am
9:45am
10:00am
10:15am
10:30am
10:45am
11:00am
11:15am
11:30am
11:45am
12:00 noon
12:15pm
12:30pm
12:45pm
1:00pm
1:15pm
1:30pm
1:45pm
2:00pm
1:15pm
1:30pm
1:45pm
3:00pm
3:15pm
3:30pm
3:45pm
4:00pm
4:15pm
4:30pm
4:45pm
5:00pm
5:15pm
5:30pm
5:45pm
2nd Reservation Date Choice
(none)
September (Fall)
October (Fall)
November (Holiday)
December (Holiday)
March (Spring)
April (Spring)
May(Spring)
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Time
9:00am
9:15am
9:30am
9:45am
10:00am
10:15am
10:30am
10:45am
11:00am
11:15am
11:30am
11:45am
12:00 noon
12:15pm
12:30pm
12:45pm
1:00pm
1:15pm
1:30pm
1:45pm
2:00pm
1:15pm
1:30pm
1:45pm
3:00pm
3:15pm
3:30pm
3:45pm
4:00pm
4:15pm
4:30pm
4:45pm
5:00pm
5:15pm
5:30pm
5:45pm
Other Information
When you have entered your informatin in the fields above
Click this
Submit
button to send your Reservation Request to Carolyn
(816) 781-9196
