Trip Reservations Name Today’s Date First Name * Last Name * Mobile Number * Email Address * Address * City * State – Select Province/State – Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Country * Group Reservation Name Group Size * *Please note that each group participant will need to fill out the registration form. Please select the tour you are interested in participating. * Michigan’s Upper Peninsula Coast-to-Coast Tour Lake Superior South Shore Tour Minnesota North Shore & Western Lake Superior Tour Payment Options * Credit Card Cashier’s Check Local Check Cash (Local residents only) Invoice will be emailed after reservation is accepted. *Deposit of 50% is due to hold reservation. **Total balance of trip is due 60 days prior to the pre-scheduled trip date. MEDICAL INFORMATION Gender * Male Female Date of Birth * Age at the time of tour dates * Height * Weight * *Information needed for certain restrictions on equipment and kayak/bike rentals. No worries…we can arrange suitable accommodations if +250lbs. Do you smoke? * Yes No Medical Restrictions/Health Concerns * Allergies Lung/Breathing restrictions/concerns Heart/Circulatory restrictions/concerns Muscular/Skeletal restrictions/concerns Other Not Applicable Please explain any of the medical restrictions/concerns from above. Please indicate your physical ability below. * Athletic physical ability Good physical ability Average physical ability Poor physical ability Blood Type (if known) Health Insurance Provider * Health Insurance Group/Policy Number * Insurance Contact Phone Number * *Please note that a photocopy of your insurance will be required by the departure date of your trip. Emergency Contact Name * Emergency Contact Phone Number * Emergency Contact Relationship * For Emergency Purposes, please list any pertinent medications. If you require an Epipen, please make sure to carry one with you. Dietary Preferences * No Restrictions Vegetarian Vegan Food Allergies / Intolerances Other Please indicate any dietary restrictions/concerns below. Trip Accommodations Do you have a tent preference? * I will share a tent with someone from my group I am traveling alone What are your interests? This will help us give you the best tour options! * Hiking Biking Paddling (Kayaking, Rafting, SUP) History/Culture Sightseeing Photography Relaxing Describe your recent camping, hiking, biking, paddling, experience below. How did you hear about Fox Hill Adventures? Would you like an airport shuttle? (Limited Availability) * Yes No Acknowledgement of Fox Hill Adventures LLC Policies * I herby certify that the information above statements and information is true and correct to the best of my knowledge. I understand that a false statement will disqualify my application. View policies at: http://foxhilladventures.com/policies/ *
