Trip Name
Trip Date

Name:
Street Address:
City/State or Province:
Country:
Zip/Postal Code:
Home Phone:
Work Phone:
Email:
Gender: male female
I am a: Smoker
Vegetarian

Accommodations:
Traveling alone (please assign a roommate)
I prefer a single room, if available
My roommate is (name of person).

If kayaking, dogsledding, skiing or snowshoeing, please indicate your weight & height for sizing
weight height

Health Concerns (allergies, disabilities, or medications, etc.):


Emergency Contact (name & phone #):

Briefly describe your outdoor interests and experience:


How did you find out about us?


Other inquiries, questions or concerns that we can answer?

*Please submit form and mail deposit (Package Trip-$100, Day Trip-$10 minimum) to P.O. Box 304, Cedarville, MI 49179. Checks and money orders please. Call (906) 484-4157 for further information.