This form is for the Edward Bailey Water Treatment Plant only.

Requester Information

School/Organization Name:

Contact First Name:

Contact Last Name:

Phone Number:

(xxx) xxx-xxxx

E-mail Address:

Organization Website:

Edward Bailey Water Treatment Plant, Tuesdays only
977 Marksheffel Rd., Colorado Springs, 80929

Age Requirement: Fifth grade or 10 years old and up
Group size: Maximum 20 attendees
Tour length: 60 minutes

Appropriate dress, which includes long pants (no dresses or skirts), closed-toed walking shoes, and clothing/accessories for expected weather, is mandatory for all tours. Due to safety concerns, visitors with inappropriate dress will not be able to tour the entire operational facility. We provide additional safety equipment, when required, to tour a facility (i.e. hard hats, safety glasses, ear protection).

TUESDAYS ONLY - PLEASE USE CALENDAR TO CHOOSE DATE

Preferred date of presentation

If preferred date is not available, second choice:

Choose one time

9am10am

Plant Tours are not available during the weeks that Colorado Springs Utilities observes a holiday.

(Martin Luther King Jr. Day, President's Day, Memorial Day, Independence Day, Labor Day, Veteran's Day, Thanksgiving and Christmas)

Number of People:

Schools must provide one adult chaperone for every 10 children (minimum)

Do any attendees have any special needs?

YesNo

if yes, please list

Do any attendees have a fear of height or loud noises?

YesNo

Please include information on special study or interest.

Additional comments or requests:

Tour and Security Policies

I have read and I understand the tour and security policies

Yes

Name

5th grade	6th grade
7th grade	8th grade
9th grade	10th grade
11th grade	12th grade
Adults