2022-2023 Eco-Explorers 5th Grade Registration Form

This form is for 5th grade classes only. Contact us for a registration form for other grade levels.

Please complete one form per field trip date in order to request a visit to Columbia Springs. We can host up to three classes per day. The more information about your class that you can provide, the better prepared we can be to meet the needs of your students! Please reach out if you have any updates closer to your field trip.

This form only serves as a request. A staff member will contact you to confirm program availability. If you have questions, please contact our field trip coordinator at schoolprograms@columbiasprings.org or 360-882-0936 ext. 226.

Click here to review the calendar of available dates.

School Contact Information

Please provide a lead contact for this request.

If we have any questions or if the date/time selected is not available, we will contact this person.

Contact Name

First Name

Last Name

School or Organization Name

School or Organization Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

School free/reduced lunch rate:

Anything we should know about the school culture?

Does your school focus heavily on science? Or more on community building? Do have special programs for mindfulness or maybe an active school garden? Do you have lots of new teachers this year? Do you have lots of change in your student body or a lot of stability? Etc.

How many classes are you registering?

A maximum of 30 children are allowed per group/class with 4-6 adults. We require a minimum adult to student ratio of 1:8.

Date of visit

MM/DD/YYYY.

Arrival Time

HH:MM AM/PM *This is the requested start time of your program. Please plan to arrive at this time. Programs may start anytime between 9am and 10am.

We will let you know if the date you selected is available. If it is not, are there other dates that work for your team?

Please confirm the program you are selecting:

This form is only for 5th grade classes registering for our Eco Explorers field trip. If you would like to register for a different field trip, please contact us for a different registration link. All classes/groups you are scheduling on the same day must participate in the same program. Up to three classes may be registered for the same day and time.

Eco Explorers (4hrs)

Payment Information:

As a small non-profit organization, program fees are just one way we keep our doors open. Additional funding comes from donations, grants and community partnerships. Program fee dollars go directly to support education, restoration and maintenance of the site.

An invoice will be sent to the district or billing contact/email below. We kindly request that all program fees be paid with a check prior to the field trip.

The Eco Explorers program fee is $240 per class.

Please select the party responsible for paying the program fee:

Program fees are $240/class for the Eco Explorers Program

Evergreen School District

Vancouver School District

Other (please list billing contact below)

Billing Contact

First Name

Last Name

Billing Contact Email

The invoice will be sent to this email address.

Class One Information

Enter information related to the first Group/Class here.

Group 1 - Teacher Name

First Name

Last Name

Group 1 - Teacher's Email

Group 1 - Number of students expected to attend:

Group 1 - Number of chaperones expected to attend:

We recommend 3-6 total adults per class, if possible.

Group 1 - Grade Level

Enter grade level of students

Group 1 - Do any of your students have photo restrictions?

If there are photo restrictions for any of your students it is your responsibility to inform chaperones.

Yes

Group 1 - Are any of your students English Language Learners?

Please include students who have recently graduated from an English Language Learners program.

Yes (please list languages spoken below)

Group 1 - Please list languages spoken by students and approximate number of students who are English Language Learners:

You may also request field guides translated into Spanish or Russian.

Group 1 - Please list any other special needs that we should be aware of:

This could include behavior issues, mobility challenges, etc. Since you may not know this information yet, please contact us as your field trip approaches with any updates.

Group 1- Are there attention-getting, calming or breathing techniques that you use in your classroom?

If we know them, we'll try to use them on the field trip to help your students.

Class Two Information

Enter information related to the second Group/Class here.

Group 2 - Teacher Name

First Name

Last Name

Group 2 - Teacher's Email

Group 2 - Number of students expected to attend:

Group 2 - Number of chaperones expected to attend:

We recommend 3-6 adults per class, if possible.

Group 2 - Grade Level

Enter grade level of students

Group 2 - Do any of your students have photo restrictions?

If there are photo restrictions for any of your students it is your responsibility to inform chaperones.

Yes

Group 2 - Are any of your students English Language Learners?

Please include students who have recently graduated from an English Langue Learners program.

Yes (please list languages spoken below)

Group 2 - Please list languages spoken by students and approximate number of students who are English Language Learners:

You may also request field guides translated into Spanish or Russian.

Group 2 - Please list any other special needs that we should be aware of:

This could include behavior issues, mobility challenges, etc. Since you may not know this information yet, please contact us as your field trip approaches with any updates.

Group 2 - Are there attention-getting, calming or breathing techniques that you use in your classroom?

If we know them, we'll try to use them on the field trip to help your students.

Class Three Information

Enter information related to the third Group/Class here.

Group 3 - Teacher Name

First Name

Last Name

Group 3 - Teacher's Email

Group 3 - Number of students expected to attend:

Group 3 - Number of chaperones expected to attend:

We recommend 3-6 adults per class, if possible.

Group 3 - Grade Level

Enter grade level of students

Group 3 - Do any of your students have photo restrictions?

If there are photo restrictions for any of your students it is your responsibility to inform chaperones.

Yes

Group 3 - Are any of your students English Language Learners?

Please include students who have recently graduated from an English Langue Learners program.

Yes (please list languages spoken below)

Group 3 - Please list languages spoken by students and approximate number of students who are English Language Learners:

You may also request field guides translated into Spanish or Russian.

Group 3 - Please list any other special needs that we should be aware of:

This could include behavior issues, mobility challenges, etc. Since you may not know this information yet, please contact us as your field trip approaches with any updates.

Group 3 - Are there attention-getting, calming or breathing techniques that you use in your classroom?

If we know them, we'll try to use them on the field trip to help your students.

Additional Information

Would you like to be added to the Columbia Springs email list?

We'll keep you informed about upcoming events and activities at Columbia Springs.

Yes, add me to the list.

No, I'm not interested at this time.

How did you hear about school programs at Columbia Springs?

Anything else we should know?

2022-2023 Eco-Explorers 5th Grade Registration Form

Visit Information

Class One Information

Class Two Information

Class Three Information

Additional Information