Field Trip Payment Form
Print and present this completed form upon arrival with one check payable to Sauder Village.

 

Tour Date:______________________________________________________________________
School/Group Name: __________________________________________________________________________
Supervising Leader:__________________________________________ Email: __________________________ 
School/Contact Phone: ______________________________________   Grade Level: __________________________
Principal's Name (if applicable):_________________________________________________________________
 
A.
 
Total Number of Students: _______________
 
at $5.00 = A. $ _____________
 
B.  
 
Total Number of Adult Chaperones: ________
 
at $8.00 = B. $ _____________
 
C.
 
Total Number of Teachers: _______________
 
FREE = C. $ ______________
 
D.
 
Total Number of Bus Drivers: _____________
 
FREE =  D. $ ______________
 
E.
 
Total Number of Ride Tickets: ____________
 
$2.00 each =  E. $ __________
 

 
If you purchase and pay for ride tickets with your admission, we will give you a special rate of $2.00 per person per ride.
 
Total Due in ONE check (total of lines A & B)
 
$  _____________
 

(Sauder Village line only) Cash refund due to illness ____ at $_______ = $_________

 

 
 Final Total $  _____________
 
* Because you are already receiving a special rate, we cannot accept any additional coupons or discounts with student group tours.
________________________________________________________________________

 

If you came to this page through a search engine, please visit our homepage at http://www.saudervillage.org