Online Program Registration

Use this form to register for up to 5 programs. Please coordinate dates and times with your teaching team to allow us to send one staff member to teach 2-5 programs in one day.

Asterisks indicate a required field to register. Your form will not submit if all fields with asterisks are not completed. When registering for multiple teachers, please complete all information including first and last names of teachers and email addresses so we can send confirmations. Please add info@naturevision.org to your safe senders list.

Full School Name/Organization Name *

School Address *

City *

Zip Code *

Billing Address

Fill out only if different than school address.

School Phone Number *

This is the line that is answered by the office during school hours.

Program 1

1) Program Name *

Program 1: Date Choice 1 *

Please see our calendar of available dates. Choose 3 possible dates in order of priority.

Program 1: Date Choice 2 *

Program 1: Date Choice 3 *

Program 1: Time Desired *

Program 1: Teacher First and Last Name *

Program 1: Teacher Email Address *

Program 1: Grade Level of Class *

Program 1: Number of Students *

30 students or fewer.

Program 1: Room Number/Field Site Desired *

Enter room number or field site location desired.

Program 2

2) Program Name

Program 2: Date Choice 1 *

Please see our calendar of available dates. Choose 3 possible dates in order of priority.

Program 2: Date Choice 2 *

Program 2: Date Choice 3 *

Program 2: Time Desired *

Program 2: Teacher First and Last Name *

Program 2: Teacher Email Address *

Program 2: Grade Level of Class *

Program 2: Number of Students *

Program 2: Room Number/Field Site Desired *

Program 3

3) Program Name

Program 3: Date Choice 1

Program 3: Date Choice 2

Program 3: Date Choice 3

Program 3: Program Time Desired

Program 3: Teacher First and Last Name

Program 3: Teacher Email Address

Program 3: Grade Level

Program 3: Number of Students

Program 3: Room Number/Field Site Desired

Program 4

4) Program Name

If you have more than 5 teachers on your team, please use fields 4 and 5 to register the extra teachers. For example enter Program Name/Program Name, Program Date Desired/Program Date Desired, Program Time Desired/Program Time Desired, Teacher First and Last Name/Teacher First and Last Name, etc. In the additional notes section, please indicate you are registering for 7 programs.

Program 4: Date Choice 1

Program 4: Date Choice 2

Program 4: Date Choice 3

Program 4: Program Time Desired

Program 4: Teacher First and Last Name

Program 4: Teacher Email Address

Program 4: Grade Level

Program 4: Number of Students

Program 4: Room Number/Field Site Desired

Program 5

5) Program Name

Program 5: Date Choice 1

Program 5: Date Choice 2

Program 5: Date Choice 3

Program 5: Program Time Desired

Program 5: Teacher First and Last Name

Program 5: Teacher Email Address

Program 5: Grade Level

Program 5: Number of Students

Program 5: Room Number/Field Site Desired

Final Information Needed

Total Cost for all programs above *

$110 for one program; $115 for one science fair or after school program; $170 for one Water Cycle Terrariums program $220 for two programs; $230 for two science fair or after school programs; $340 for two Water Cycle Terrariums programs $330 for three programs; $345 for three science fair or after school programs; $510 for three Water Cycle Terrariums programs $440 for four programs; $460 for four science fair or after school programs; $680 for four Water Cycle Terrariums programs $550 for five programs; $575 for five science fair or after school programs; $850 for five Water Cycle Terrariums programs Please note that some of our programs are free. If you saw a flier or email that specified certain programs are sponsored for your school, you do not need to worry about payment when you register: https://naturevision.org/free-programs-for-schools

Information about your class:

More than 30 students

High percent ELL

Other (please list under additional notes)

Any additional notes for us?

Additional Information for Teachers: 30 students maximum. A teacher or responsible adult must be present for the program at all times. Field trip site closest to you will be chosen unless otherwise specified. Please schedule 2-5 classroom or field programs per date selected for your school. This allows us to send available staff and supplies in the most efficient way possible. We will invoice you for programs unless they are free (sponsored).

LIMITATION OF LIABILITY AND INDEMNITY *

TYPING YOUR NAME BELOW SERVES AS YOUR DIGITAL SIGNATURE. THE ABOVE NAMED SCHOOL AGREES TO RELEASE AND HOLD NATURE VISION, ITS OWNERS, EMPLOYEES, VOLUNTEERS AND DIRECTORS HARMLESS TO THE EXTENT PERMITTED BY LAW, FROM AND AGAINST ALL CLAIMS, DEMANDS, SUITS, PENALTIES, LOSSES, DAMAGES, JUDGMENTS AND COSTS OF ANY KIND ARISING OUT OF OR IN ANY WAY RESULTING FROM THE ACTIVITIES OF STUDENTS, TEACHERS, VOLUNTEERS, PARENTS OR OTHER DISTRICT OR SCHOOL PARTICIPANTS IN NATURE VISION ACTIVITIES, INCLUDING TRANSPORTATION TO AND FROM NATURE VISION ACTIVITIES. THE ABOVE NAMED SCHOOL RELEASES AND AGREES TO INDEMNIFY NATURE VISION, ITS OWNERS, EMPLOYEES, VOLUNTEERS AND DIRECTORS FOR ALL LOSSES, DAMAGES, JUDGMENTS, COSTS AND EXPENSES OF ANY KIND ARISING OUT OF OR IN ANY WAY RESULTING FROM THE ACTIVITIES OF STUDENTS, TEACHERS, VOLUNTEERS, PARENTS OR OTHER DISTRICT OR SCHOOL PARTICIPANT IN NATURE VISION PROGRAMS, INCLUDING SETTLEMENT PAYMENTS, COURT JUDGMENTS AND REASONABLE LEGAL DEFENSE FEES.

Today's Date *

Today's Date

YYYY

Payment Options *

Choose Free Program (Sponsored) http://naturevision.org/free-programs-for-schools, or scroll down to choose Invoice. You will receive a confirmation once we have received your registration. If you choose "Invoice" you will be billed later. You must click "Submit" upon completion of this form, or we will not receive your registration.

Program Sponsor (if you know) *

Please select your program sponsor from the drop down if this is a free program.