Gold Rush Field Trip Reservation Name First Last School Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Number of Students Number of Teachers Number of Chaperones Date of Your Trip MM slash DD slash YYYY 1st ChoiceDate of Your Trip MM slash DD slash YYYY 2nd ChoiceDate of Your Trip MM slash DD slash YYYY 3rd ChoiceThank you for completing our on-line field trip reservation form. A member of our staff will get back to you within 3 work days to confirm your reservation. Once your trip has been confirmed, you will receive our reservation packet. Your trip will a require a $300 deposit (applied to your program) within 2 weeks of reserving your date(s)CAPTCHANameThis field is for validation purposes and should be left unchanged. Δ