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2. FIELD TRIP INFO
4. Field Trip
   -- Select One --Burnet WoodsCincinnati Zoo: America Recycles DayCivic Garden Center: Compost KidsGorman Heritage Farm: Reducing Food WasteGreenacres: Nature of RecyclingLa Soupe: Food Rescue and TransformationRumpke's Landfill TourRumpke's Landfill Tour and Burnet Woods ComboRumpke's Material Recovery Facility
6. Are you staying for lunch at the Civic Garden Center?

   1. Yes
   2. No
8. Lunch Option

   1. Packing lunches to eat on site
   2. Not staying
10. 1st Preferred Date & Time
    1st Preferred Date & Time

    1st Preferred Date & Time
11. 2nd Preferred Date & Time
    2nd Preferred Date & Time

    2nd Preferred Date & Time
12. 3rd Preferred Date & Time
    3rd Preferred Date & Time

    3rd Preferred Date & Time
14. Grade
15. # of Students
16. # of Chaperones
20. TEACHER INFO
22. First Name
23. Last Name
25. Phone Number
26. Email Address
30. SCHOOL INFO
32. School Name
34. Address
35. Zip Code
37. Are you a Let's Stop Waste School?*

    1. Yes
    2. No

    If you are unsure of your school's status, please reach out to elise.roalef@hamilton-co.org.

39. Please read and confirm*

    1. I understand that if my school is not registered with the Let’s Stop Waste program, we are NOT eligible for reimbursement.
41. Field Trip
42. School
44. First Name
45. Last Name
47. Requested Bus Reimbursement
49. Applications must agree to the following:

    I will turn in student reflections within 10 days of our field trip or my right to future field trips will be forfeited.
    
    I understand that I am responsible for scheduling any required bus transportation to and from the field trip. If the trip is cancelled for any reason, I must notify the transportation provider at least two hours prior to the school pick-up time or I may be responsible for late cancellation expenses charged by the bus provider which are not subject to reimbursement. 
    
    I understand that a minimum of five weeks is required for processing reimbursements and reimbursement requests must be submitted within 90 days of the trip, (120 for America Recycles Day) or my right to reimbursement will be forfeited.
    
    My principal is aware that I am applying for this field trip and has agreed to allow my students to miss class time to attend.
    
    I, on behalf of myself and my school, understand and agree that neither the Hamilton County Recycling and Solid Waste District nor its principles or employees shall be held liable for damages or injuries that may arise out of the field trip or the transportation.

    1. I agree
51. Electronic Signature
52. Date
    Date
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field