(STAGING) Carol Stream Park District

Agency Name*
Group Name*
Contact Name*
First Last
Contact Email*
Contact Office Phone*
Day of Event Contact Cell Phone*
Contact Birthdate*
MM slash DD slash YYYY

(required in order to set up an account)
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Best Way and Day/Time to Reach You*
Number of Guests*
Age/Grade Range of Guests*
Facility Selection(s)*
- Gymnastics – Simkus Recreation Center
- Mini Golf – Coyote Crossing Mini Golf
- Swimming – Coral Cove Water Park
- Swimming – Fountain View Indoor Pool
- Putt & Play Combo – Coyote Crossing Mini Golf & McCaslin Park
- Flip & Dip Combo – Simkus Recreation Center & Coral Cove Water Park
Add On
- Splash Pad (Mini Golf or Putt & Play Combo Only)
Requested Trip Date*
MM slash DD slash YYYY
Start Time

: Hours

Minutes

AM/PM
End Time

: Hours

Minutes

AM/PM
Additional Notes or Requests*
How did you find out about us?*
- Attended previous field trip
- Referral
- Email
- csparks.org
- Other

Group Outing Request