Field Trip Request Form

Field Trip Request Form

To request a field trip, simply fill out the form below and our staff will follow up with you shortly!

* Required fields
Name *
E-mail Address *
School/Group Name *
School Address *
City *
State
Zip *
School Phone *
Number of Students *
Grade level *
Number of Teachers
Number of Parents
Do you need lunch space? *	Yes No
Lunch space needed at: (this reservation will be made for you by our staff)	Cochran Mill Nature Center - includes covered pavilion with tables & seating for 60 Cochran Mill Park -1 mile from the Nature Center, includes covered pavilion for large groups & playground
Is your group: *	Bilingual Special Needs Other None
If yes, please describe the above
Please indicate 3 date preferences *
Preferred time of arrival *
We must depart by (programs typically run 90 minutes): *
Each visit includes 3 programs. Please indicate your 1st choice: *
2nd choice *
3rd choice: *
Would you like to spend time in the Gift Shop? *	Yes No Please send me a catalog for pre-visit orders
How did you hear about us? *
	I understand that this request is NOT a confirmation for a field trip program *
	I understand that I will be contacted via e-mail by a CMNC staff member regarding this request *
	I understand that a $90 deposit is due 30 days before the date of the program. If this deposit is not received, we reserve the right to cancel your reservation. *

I have read and agree to the Privacy Policy *

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Cochran Mill Nature Center

6300 Cochran Mill Road Palmetto, GA 30268

Phone: (770)306-0914 Fax (770) 306-8463