ROGER'S RANGERS CAMP

RESERVATION FORM

FIRST NAME:     LAST NAME: 

ADDRESS: 
CITY:    STATE:     ZIPCODE:

PHONE:         CELL: 

EMAIL: 

TYPE OF STAY:
FAMILY VACATION:       ROMANTIC GETAWAY     GROUP 
NUMBER OF GUESTS TO STAY:

 ORGANIZATION:     NAME OF ORGANIZATION: 

GOAL OF STAY:
HUNTING       SKI         FISH       BIKE        SNOWMOBILE        R & R 

SEASON OF INTEREST TO STAY:

WINTER                    SPRING                       SUMMER                        FALL   

DATES YOU DESIRE: 

START DATE:       END DATE:

ANY NOTES, RESTRICTIONS OR SPECIAL NEEDS:

TO RESERVE DATE:
TYPE OF CREDIT CARD::
 MC    VISA    DISCOVER   AMERICAN EXPRESS   OTHER: 

CREDIT CARD #       
EXPIRATION DATE: 
NAME ON CREDIT CARD: 

Depending on availability, we will confirm or offer alternate dates within 48 hours.  Thank you for your interest in Roger's Rangers Camp.  We will contact you by phone to confirm your reservation and for any questions you may have.

Ernie Gaskin
765-779-5048