Request for Kids on the Block presentations School* County* Promo Code Thanks to our funders at United Way of Rutherford and Cannon Counties, we're able to provide you with the presentations at no cost to your school Thanks to the Nashville Predators Foundation, we're able to provide Fort Campbell Schools with presentations at no cost to your school. Please note that there will be a $150 travel fee for your school. Please note that there will be a $175 travel fee for your school. Contact Person* Your Name* First Last Position* Phone Number* Email* Three Possible Dates (Tuesday-Wednesday): Date 1* Date 2* Date 3* Program selections (select up to 3): Selection 1 Topic*Teasing & Name-Calling – Kindergarten (25 minutes)Awareness of Differences – First Grade (45 minutes)Talk it Out (45 minutes)Child Abuse Prevention (45 minutes)Be a Hero (45 minutes)Select grade*Second GradeThird GradeFourth GradeSelect grade*Third GradeFourth GradeStart Time* : Hours Minutes AM PM AM/PM Please allow 15 minutes between presentations with no more than a 60 minute break.# of classes* # of students* We recommend a maximum of 150 students per presentation. I would like to schedule another presentation:*NoYes Selection 2 Topic*Teasing & Name Calling - Kindergarten (25 Minutes)Awareness of Differences - 1st Grade (45 Minutes)Talk it Out - 2nd Grade (45 Minutes)Child Abuse Prevention - 3rd Grade (Recommended 60 Minutes)Start Time* : Hours Minutes AM PM AM/PM Please allow 15 minutes between presentations with no more than a 60 minute break.# of classes* # of students* We recommend a maximum of 150 students per presentation. I would like to schedule another presentation:*NoYes Selection 3 Topic*Teasing & Name Calling - Kindergarten (25 Minutes)Awareness of Differences - 1st Grade (45 Minutes)Stand Up-Resolving Conflict and Reporting Bullying - 2nd Grade (45 Minutes)Child Abuse Prevention - 3rd Grade (Recommended 60 Minutes)Be A Hero - 4th Grade (Recommended 60 Minutes)Start Time* : Hours Minutes AM PM AM/PM Please allow 15 minutes between presentations with no more than a 60 minute break.# of classes* # of students* We recommend a maximum of 150 students per presentation. I would like to schedule another presentation:*NoYes Selection 4 Topic*Teasing & Name Calling - Kindergarten (25 Minutes)Awareness of Differences - 1st Grade (45 Minutes)Stand Up-Resolving Conflict and Reporting Bullying - 2nd Grade (45 Minutes)Child Abuse Prevention - 3rd Grade (Recommended 60 Minutes)Be A Hero - 4th Grade (Recommended 60 Minutes)Start Time* : Hours Minutes AM PM AM/PM Please allow 15 minutes between presentations with no more than a 60 minute break.# of classes* # of students* We recommend a maximum of 150 students per presentation. Supervision provided by (check one):*Classroom teachersRelated Arts teachersPerformance location (quiet rooms such as a library are best):* How did you hear about us?*EmailSocial MediaWebsiteReferralPrint Promotional (Postcard, brochure, etc.)OtherPlease tell us who referred us.* We would love to give them an extra hug.Tell us how you did hear about us.* We would love to give them an extra hug.Additional Comments Δ