NOAH’S WILDERNESS ADVENTURES INC.
P.O. Box 763, Phoenix, OR 97535
(541) 261-2677
WWW.NOAHSFISHING.COM e-mail:
GUEST QUESTIONNAIRE FORM
GROUP LEADER- ______TRIP CODE – _FRRC3OR4DL_DATE______
Hello, in preparation for your wilderness fishing adventure with us, we ask that each of you supply us with the following information so that we may provide you with the best possible safety, customer service and comfort. Thank you very much!
1. Your Name: ______Phone #______
2. E.mail address:______
3. Mailing address: ______
3. Your age:______height:______weight:______
4. Any dietary restrictions or specifications?______
5. Beverage preferences for soda :(bottled water-iced tea-lemonade always included) (Please note that due to Insurance regulations we are not able to provide alcoholic beverages. Please feel free to bring your favorite choice of canned beer, bottled wine or liquor)
Pepsi_____ Diet Pepsi_____ Coke_____ Diet Coke_____ Sprite_____ Root Beer_____
6. IF you plan on bringing your own soda/beer/wine/liquor/mix, please let us know so we can pack accordingly including unbreakable storage containers and extra Ice.. ______
______
7. Any special physical conditions, which we may need to be aware of: ______
______
Asthma, diabetes, anaphylactic shock, pregnancy, recent surgeries (last 6 months), back problems, other)
8. Do you need assistance for travel and/or lodging arrangements before or after this trip? ______
9. Do you plan on returning to your original rendezvous point with us? (y/n)______or would you like to have your vehicle shuttled to Q-Creek or Foster Bar (river take out point for this activity? (y/n)______Please note: There is an additional $110.00 fee per vehicle for shuttle services provided by Sam and Dave Waters and two sets of keys are required to accomplish the shuttle and maintain vehicle security.
10. Are there any special occasions for your party which you plan on celebrating during your fishing trip(birthday, anniversary)? Yes_____ No_____ If yes, please let us know how we can assist you: _____(on reverse side)______
11. Questions/comments:______
We look forward to sharing this river adventure with you. Please return this questionnaire at least 10 days prior to your trip via mail or e-mail, thank you.