Experiences

Virtual Ivan Wild Within Request Form

Non-Refundable deposit of $50 is due at the time of reservation. Final head count is due 4 WEEKS before your scheduled program.

*Organization Name:

*Type of Organization:

(school, daycare, scouts, etc.)

*Organization Street Address:

*Organization City:

*Organization State:

*Organization Zip Code:

Organization County:

*Main Contact First Name:

*Main Contact Last Name:

*Main Contact Email:

*Main Contact Phone:

*Are you a tax exempt organization?

Yes
No
Not Applicable

*Are you a Title 1 School?

Yes
No
Not Applicable

*First Preferred Date:

*Second Preferred Date:

*Preferred Start Time:

45 minute program

*How many students will be participating?

The maximum capacity is 30 participants (total including adults and children) per time slot.

*How many adults will be participating?

The maximum capacity is 30 participants (total including adults and children) per time slot.