Pumpkin Palooza
| Saturday, October 26
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School/Organization/Group Information
School/Organization/Group Name
*
School District (if applicable)
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Contact Information
Contact Person
*
First
Last
Contact Person Title
Contact Phone
*
Contact Email*
*
Group Information*
*
Teacher Name
Grade Level
Number of Children
Requested Lab
Grade Level
PreK
Kindtergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Requested Lab
DCM Dream Playground
Create A Creature
Build A Bridge
Epic Art
Sound All Around
Mystery of the Suspicious Substance
Wings & Things
Nature's Adventure
Date/Time Requested
Requested Date (1st Choice)*
*
MM slash DD slash YYYY
Requested Date (2nd Choice)*
*
MM slash DD slash YYYY
Requested Start Time*
Chosen Format*
*
At DCM
In Your Classroom
Would you like to include a Field Trip with your lab? (For Labs at DCM Only)
Yes
No
Additional Requests/Questions
Do you have any additional requests?
Do you have any additional questions?
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