PERSONAL PREFERENCE FORM

Please complete this entire form. In addition to the information needed for safety reasons, this data will be used to have all preparations ready on your arrival and to ensure your every need will be met during your stay. Trip:   Dates:   Coordinator (if part of group):   Phone:   Your Information: Full Name   Email Address   Street   City   Province/State   Postal/Zip   Home Phone   Home Fax   Business Information: Business Name   Email Address   Street   City   Province/State   Postal/Zip   Business Phone   Business Fax   Emergency Contact: Name   Relationship   Address   City   Province/State   Country   Postal/Zip   Home Phone   Business Phone   Fishing Licenses: Will you need a B.C. saltwater fishing license? Yes No Will you need a B.C. freshwater fishing license? Yes No Date of Birth Driver's License No. Passport No. Birth Certificate No. or Permanent Resident Card No. Gear: Please indicate what activities you are interested in participating in while at the lodge: Saltwater fishing Saltwater fly fishing Fly fishing Hiking Kayaking Wildlife viewing Cultural tours Activities: Rainwear Size: S M L XL XXL Rubber Boot Size: Weight: Requirements: Do you have any particular special requirements? (dietary restrictions, disabilities, allergies etc.) To make your trip as memorable as possible, please advise if any members of your party will be celebrating a special occasion during your stay (ex: birthday, anniversary). Also, please list any special requests that you may wish to include: