RESERVATION REQUESTS
(This is not a confirmation. All reservation requests need to be confirmed by U.S. Rafting staff)

First Name:				E-mail:
Last Name:				Tel:	(### - ### - ####)
Address:				Referred By:	Please Select... Family Friend Internet Printed Ad Radio Other
Apt #:				Comments:
City:
State:		Please Select... Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick Newfoundland New Hampshire New Jersey New Mexico New York North Carolina North Dakota Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip:

* Enter Security Code:

Enter the security code that you see in the image before clicking on the Submit button. If you can not read the image, click on the New Image button to get a new image.

** DO NOT WEAR ANY COTTON ON THE RIVER **
(Cotton holds in the water causing you to become cold.)

AND DON'T FORGET A TIP FOR YOUR GUIDE!