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Generic Form

* School or Organization Name

* Contact Name

* Contact Title

* Please check the best way(s) to contact you:

Office Phone

Cell Phone

* Office Phone:

* Cell Phone:

* Contact Email Address:

* School / Organization Street Address:

* School / Organization City:

* School / Organization State:

* School / Organization Zip code:

* County:

Non-Profit EIN #

Public School FRPM %

* Number of Participants (numbers only):

* Participant Age Range (numbers only):

* Number of Staff / Volunteers (numbers only):

PROGRAM INFORMATION

* Biking field trips seat up to 20 participants including staff and/or chaperones, or, we can do 2 rotations of up to 20 each rotation (40 seats for 2 rotations).

We have a small number of bikes that fit participant’s heights under 5 feet tall. Please specify how many of your participants are under 5 feet tall.

REQUESTED DATE(S) OF PROGRAM
(PROVIDE 3-4 CHOICES)

* Requested Date # 1:

* Requested Time # 1 (From & To):

* Requested Date # 2:

* Requested Time # 2 (From & To):

* Requested Date # 3:

* Requested Time # 3 (From & To):

Requested Date # 4:

Requested Time # 4 (From & To):

GENERAL INFORMATION

We do not teach participants how to ride a bike; but rather how to have a safe, fun, and rewarding experience of their Regional parks and trails. Basic biking experience is required.

* What type of transportation do you plan on using?

If your group needs a subsidized bus, apply here: www.epbarks.org/parks/publictransit/parks-express

* Have you participated in an EBRPD boating program before?
If yes, provide trip date and location.

If you answered yes above, provide trip date and location:

* How did you hear about our Field Trips?

Specify any special needs?
For example: mobility, visual, hearing, language, etc.:

PARK SELECTION Choose the park(s) that you would like for your field trip

PROGRAM DAY and TIME

* Choose ONE program length that works best for your group:

One 1.5 hour program

Two 1.5 hour programs (2 groups rotate)

One 2.0 hour program

Two 2.0 hour programs (2 groups rotate)

One 3.0 hour program

PROGRAM FEE

Please review the PROGRAM FEE CHART to determine the cost of your Biking Field Trip.

Please calculate your fee:
Base Fee Amount times the Discount percentage* (%) = Total Amount Due
*If applicable

* Total Amount Due ($):

ADDITIONAL REQUESTS We may be able to schedule a naturalist (depending on availability) to provide natural and cultural history lessons on the trip. Are you interested in adding a naturalist to your trip?

Interested in adding a naturalist?

Yes

List any themes you would like us to cover:

Captcha:

Thank you for applying for an Outdoor Recreation BOATING Field Trip! Our staff will contact you within two weeks of receiving your application.

PAYMENT Once your trip is confirmed, payment is due in full 15 days prior to the program. The Outdoor Recreation Department will send you an email confirming your field trip that will include instructions on how to complete payment along with details of your program.

CANCELLATION POLICY Refunds will be offered upon request up to 7 days prior to the trip. Any cancellation within 7 days will require a written letter of explanation. Refunds will be issued at the discretion of the Recreation supervisor. In the case that programs are cancelled by the Park District due to unsafe weather conditions, your group will be rescheduled if possible or refunded the fees.

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