Register for Children and Hospitals Week | Norton Children's Louisville, Ky.

Name of School*

Contact Person*

Email Address*

Street Address 1*

Street Address 2

City*

State*

Zip*

Phone Number*

How would you like to be contacted?*

How many classes?

Total number of students attending*

Check what day(s) your students CANNOT attend

Flexibility is extremely important. The more available dates and times, the better chance of classes being scheduled for the field trip.

Earliest possible arrival time*

Latest possible departure time*

Additional comments