GROUPS DATE REQUEST FORM
(Please submit this request at least 14 days prior to the visit date)
* Required
Email address
*
Your email
Group Name
*
Your answer
Leader Name
*
First & Last
Your answer
Mailing Address
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
Primary Phone
*
Your answer
Alternate Phone
*
Please list a cell phone number for the day of your visit. Note: only Verizon customers have service at Dodge Ridge.
Your answer
Trip Date
*
(Holiday rates apply Dec 24-Jan 2, MLK Weekend Jan 14-16, Presidents Day+ Ski Week Feb 18-24)
MM
/
DD
/
YYYY
Alternate Trip Date (or Trip Date #2)
MM
/
DD
/
YYYY
Trip Date #3
MM
/
DD
/
YYYY
Trip Date #4
MM
/
DD
/
YYYY
Group Size
*
(Approximately how many people in your group?)
Choose
15 (minimum)
20
30
40
50
75
100
Over 100
Group Type
*
Choose
Public School (K-12)
Private School (K-12)
College/University
Church
Scouts
Family
Work
Please list any additional comments, questions or requests here:
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Dodge Ridge Corporation.
Report Abuse
Forms