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?*
- Email
- Phone
- Leave message with office
How many classes?
Total number of students attending*

Flexibility is extremely important. The more available dates and times, the better chance of classes being scheduled for the field trip.
Check what day(s) your students CANNOT attend
- Monday, February 24
- Tuesday, February 25
- Wednesday, February 26
- Thursday, February 27
- Friday, February 28
Earliest possible arrival time*
Latest possible departure time*
Additional comments

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