2. Please Note: Submitting this application form does not guarantee a booked program. Patuxent River Park’s Program Coordinator will be in touch to firm up details. Only when you have received a confirmation/invoice is your program considered booked. 

4. Organization Name:*

   (if not applicable, type N/A)

6. Organization or Program Coordinator Street Address:*
7. City*
9. State*
10. Zip Code*
12. Coordinator Name:*
14. Phone Number(s):*
15. Email Address:*
17. Have you coordinated a program with the park before?

    1. Yes
    2. No
21. Requested Program:*
    -- Select One --*Estuary Experience (All Grades and Ages)*Guided Wetland Nature Hike (All Grades and Ages)*River Ecology Boat Tour (All Grades and Ages)
Bugs and Blooms Nature Craft Program (Pre-K to K)
Tree Leaves Nature Craft (Pre-K to K)
Sweet Pollinators (K-5th)
Tidal Treasures (K-5th)
Beaver Tales (K-5th)
Watershed Connections (6th-12th)*Guided Kayak Trip (6th-12th)*Rural Life Museums Tour (Adults, Seniors)
*Birding Trip (Adults, Seniors)
The Traveling Naturalist (Adults, Seniors)Other (Please specify below)

    *Onsite Only Programs

    Please visit pgparks.com/3418/Education for more detailed program information. 

23. Other Requested Program (if not listed):
25. Please list any specific subjects or themes you would like us to touch on during your program:
29. Preferred Date & Start Time (Option 1)*
    Preferred Date & Start Time (Option 1)

    Preferred Date & Start Time (Option 1)
30. Preferred Date & Start Time (Option 2)*
    Preferred Date & Start Time (Option 2)

    Preferred Date & Start Time (Option 2)
31. Preferred Date & Start Time (Option 3)*
    Preferred Date & Start Time (Option 3)

    Preferred Date & Start Time (Option 3)
33. Number of Attendees

    Note: We can only accommodate groups of 60 or less per day. Additionally, groups must have at least 10 attendees or pay for 10. 

35. Number of Attendees:*
36. Number of Chaperones:*
38. Grade Level and/or Age Range of Attendees:*
40. Special Accommodations Needed:
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field