CALL OF THE WILD
"Secure" Reservation Form

23 Edward St., Markham, Ontario, L3P 2N9, Canada

Type of Trip: Date of Trip (dd/mm/yy):

Mr. Ms. Name: Age:

Occupation:

No. People in Party:
Names and Ages of Others (name - age):

Mailing Address
Address Line 1:
Address Line 2:
City:
Prov./State (please use the 2 letter abbreviation if you are in North America):
Postal/Zip Code:
Country:

Phone Home: Phone Work: Fax:
E-Mail:

Camping Experience: None Some Much

Do you require transportation from Toronto ($130/person)? Yes No

Equipment Rentals
Dry-Bags for your clothes ($30/trip - Recommended 1/person on Canoe trips):
Camera Dry-Bags ($10/trip):
Sleeping Bags ($30/trip - Canoe trips only):

Health Problems, Dietary Considerations, Allergies, Special Requirements:

How did you hear about us?


Payment

Deposit
Registration must be accompanied with a 25% deposit per person. This can be done with Visa, MasterCard, American Express, a money order, or a personal cheque. If you are paying by cheque we will hold your reservation for 10 days after receipt of this form for your cheque to arrive. After 10 days we will null the reservation. Payment in full is required 4 weeks prior to the trip departure date. Make cheques or money orders payable to "Call Of The Wild".

Cancellations
Cancellations will be refunded, less a $50 administration fee, up to 2 weeks prior to departure, thereafter only a 25% refund is possible.

Note: This IS a "secure document". It has encryption, just check the bottom of your screen for the "Lock" icon. If you prefer not to give out your credit card information over the Internet, please phone or fax the information to us at Tel: 905-471-9453, Fax: 905-472-9453. But please fill out the rest of this form.

Credit Card: American ExpressVisa MasterCard Life Experiences

Name on Card:
Amount (Canadian Dollars): $
Card Number: Expiry (mm/yy):


Release & Consent

I am fully aware that the trip for which I am registering contains an element of risk. I hereby release and forever discharge Call Of The Wild, its owners, and its employees of and from all actions, causes of actions and claims of every nature or kind whatsoever, however caused, occurring as a result of, or in any way connected with, my, or my children, participating in the above listed trip, and absolve Call Of The Wild, its owner, and its employees for any and all negligence. I accept complete and full responsibility for my own personal safety and belongings. I am over 18, and am in good physical condition. I realize, and give my consent that any photo taken of me during the course of the trip can be used for promotional purposes.

By typing your name below you acknowledge that you have read, understood, and agreed to the above Release & Consent. This will serve as your electronic signature. After filling out this form you should print a copy for your records.

Legal Signing Name:
Today's Date (dd/mm/yy):


Press to clear the form, or press if the information is correct.