Children’s field trip in New York





Participant’s Name:

Your email:

Home phone

Your Date of Birth (DD/MM/YYYY):

School Name:

Work Phone:

Address:

As parent/legal guardian of I register him/her to participate in the field trip.

Would you be able to volunteer for the field trip?

Preferred payment method (check box):

(Payable to IBREA Foundation. Send to 866 UN Plaza Room 479 New York NY 10017, and specify “Field Trip”)

Does the child you are subscribing have any health problems or specific needs? Please specify.

Availability (Check boxes):