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2. Please note that you may be contacted for more information to prepare your program; the time is not reserved until you receive confirmation from the Education Coordinator. Payment is due prior to the start of your program.
4. Contact Information
6. Full Name*
8. Address 1*
9. Address 2
11. City*
12. State*
13. Zip Code*
15. Email*
16. Phone*
18. Program Information
20. Type of Program*
    -- Select One --Informal Animal Enounter $25Formal Animal Chat $40Guided basic tour $75Behind-the-Scenes Tour $100Behind-the-Scenes Tour with animal encounter $150Classroom-Style Program for school groupsWorkshop-style Program for school groupsGuided Tours for a single class
22. Grade of Age Range*
24. Number of Students*
25. Number of Chaperones*
27. Requested Date / Time*
    Requested Date / Time

    Requested Date / Time
28. Back-up Date / Time
    Back-up Date / Time

    Back-up Date / Time
30. Other Information
32. Special Requests?
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field