B&B Charters Online Reservation Form

B&B Charters Inc Worldwide Fishing Adventures
Fishing / Hunting Trip Reservation Form

Trip Name:__________________________________ Arrival Date:_______________________________

Full Name ( as it appears on your passport ) : ________________________________________________

Address :______________________________________________________________________________

City :_______________________State :________________________Zip :__________________________

Homephone :____________________Day-time phone :___________________Fax :__________________

Personal Data :

Age :_____Occupation :____________________________Weight (necessary for charter flights) :______

Nationality :__________________Passport Number :___________________Expiration Date:__________

State of Health :_________________________________________________________________________

In case of emergency, please notify :__________________________Relation :______________________

Address : _____________________________________Telephone:________________________________

In case an emergency arises, what medications are you taking?__________________________________

List your allergies to medication :___________________________________________________________

Are you allergic to bee stings?___________

Do you have any special dietary requirements?_______________________________________________

Accommodations :
I would like to share a room with (name)_____________________________________________________

I am traveling alone:_______Please assign a roommate: Yes_____No_____Smoker___Non-smoker____

I desire single hotel accommodations if available (single supplement charge may apply) : Yes_______No_______

Payment:

I am enclosing $____________per person deposit to reserve space on the above departure date.

Release of Liability and Assumption of Risk:

I have read and agree to the conditions, especially noting the policy on cancellations and refunds as stated in B&B Charters Worldwide Fishing Adventures General Terms and Conditions policy statement on the link at the bottom of this page..

Signature:_________________________________________Date:________________________________

B&B Worldwide Fishing Adventures                                                                   Toll-Free (888)-479-2277
1416 1/2 E. 10th Place                                                                                   (541) 296-3962
The Dalles, OR 97058                                                                                               Fax (541) 296-9144