NOTE: PLEASE USE THE TAB KEY OR YOUR MOUSE TO GO TO THE NEXT FIELD; ENTER OR RETURN KEYS WILL SUBMIT THE FORM.

Name:

Address:

City:

State: Zip Code:

E-mail Address:

Daytime Phone:

Evening Phone:

TRIP DESIRED: (select one)
Trout Float Smallmouth Float Overnight
Walk/Wade Day Wade Flyfishing School

DATE DESIRED: Choose Month January February March April May June July August September October November December Choose Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Number of people in your party:

Level of expertise: (select one)
Beginner Intermediate Advanced

Equipment needed: (check all that apply)
Rods; if so, number of rods: number of rods 1 2 3 4 5 6 7 8 9 10
Waders; if so, number of waders: number of waders 1 2 3 4 5 6 7 8 9 10
Wading Boots; if so, indicate all shoe sizes:

Person 1 Shoe Size: select size mens 5 mens 6 mens 7 mens 8 mens 9 mens 10 mens 11 mens 12 mens 13 mens 14

Person 2 Shoe Size: select size mens 5 mens 6 mens 7 mens 8 mens 9 mens 10 mens 11 mens 12 mens 13 mens 14

Person 3 Shoe Size: select size mens 5 mens 6 mens 7 mens 8 mens 9 mens 10 mens 11 mens 12 mens 13 mens 14

Person 4 Shoe Size: select size mens 5 mens 6 mens 7 mens 8 mens 9 mens 10 mens 11 mens 12 mens 13 mens 14

Please remeber to bring a raincoat and polarized sunglasses.
NO CLEATS PLEASE - felt-bottom boots only for all rafting trips.

Is anyone in your party allergic to shellfish (crab cakes)?
Yes No

How did you hear about Elk Creek Outfitters? choose one: recommended by a friend found website on internet print advertisement other

Please specify publication, website, or other source which referred you to Elk Creek Outfitters:

Method of payment:
choose one: credit card check

We require a 50% deposit to reserve your date. We can take this via credit card or pencil you in if you prefer to send a check. Upon receipt of your check, we will "ink" you in on the calendar. Please submit this form and you will be contacted as soon as possible for confirmation.