LOUISIANA PURCHASE RANCH OUTFITTERS
LIC. NO. 2127 HUNTER INFORMATION & RESERVATION FORM 970-272-30.06
P O BOX 206, MEEKER, CO. 81641
shootelk@earthlink.net
NAME: ________________________________________ DRIVERS LIC. NO.: ________________________
ADDRESS: _____________________________________ SOCIAL SEC. NO.: ________________________
CITY: _________________________________________ BIRTH DATE: ________________________
STATE: _______________________ ZIP: ____________ IF ON OR AFTER 1/1/1949 YOU MUST
PHONE NO.: ___________________________________ HAVE A HUNTER SAFETY CARD
EMAIL:________________________________________ C. I. D. # _____________________________________ *
METHOD OF PAYMENT: CASH: ________ MONEY ORDER: _________ CHECK NO. _____________
IF FLYING, DATE OF ARRIVAL: ________________ FLIGHT NO. ___________ TIME: ____________
RIFLE: 1ST: ___ 3RD: ___
SEASON: ARCHERY: ___ BLACK POWDER: ___ 2ND: ___ 4TH: ___ NOV. P. L. COW ELK HUNT: ___
ELK ONLY: ___ DEER ONLY: ___ DEER/ELK COMBO: ___ COW ELK: ___ DEC. COW ELK HUNT: ___
TYPE OF HUNT BOOKED: FEE EACH TOTAL
TRESPASS W / ACCOMMODATIONS: ___ ___________ _____________
TRESPASS: ___ ___________ _____________
SEMI-GUIDED: ___ ___________ _____________
GROUP CAMP: ___ ___________ _____________
PERSON TO CONTACT IN CASE OF EMERGENCY: ___________________________________________
PHONE: ___________________________________________
Pursuant to section 12-55.5-105(1)(c) and (1)(d) outfitters are bonded and required to possess the minimum level of liability insurance and the activities of outfitters are regulated by the director of the division of registrations in the department of regulatory agencies.
PLEASE NOTE THAT THE LOUISIANA PURCHASE RANCH IS NOT LIABLE FOR ANY LOSS THAT YOU MAY INCUR DURING YOUR STAY WITH US. THERE IS NO GUARANTEE OFFERED NOR IMPLIED AS TO THE SUCCESS YOU OR YOUR PARTY MAY HAVE ON ANY OF OUR HUNTS. HUNTERS NOT SUCCESSFUL IN THE DRAW WILL BE ALLOWED TO HUNT IN ANOTHER AVAILABLE SEASON.
THANK YOU,
THE MANAGEMENT
PLEASE ACKNOWLEDGE YOUR ACCEPTANCE OF THIS RESERVATION BY SIGNING THIS FORM.
SIGNATURE:
_________________________________________________ DATE: ______________________NOTES:
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
A NON-REFUNDABLE DEPOSIT OF 50% IS REQUIRED WITH EACH RESERVATION.
YOUR CONTRACT WILL BE SENT TO YOU UPON RECEIPT AND CLEARANCE OF YOUR DEPOSIT.