Wilderness Photography Expeditions

TRIP RESERVATION FORM

Please print and mail with your deposit of $500.00 per person to
Wilderness Photography Expeditions, 517 West Geyser St, Livingston, MT 59047 406-222-2986

Destination and Departure Date: _________________________________________________________________________

 

Applicant's Name ________________________________

Address________________________________________

City___________________________________________

State _________________________ Zip _____________

Email _________________________________________

Telephone (Day)_________________________________

Telephone (Eve) _________________________________

Birth Date _____________________ Sex _____________

  ____Smoker             ____Non-Smoker

Occupation _____________________________________

Special Health or Dietary Concerns (any foods you especially dislike) _______________________________________________
_______________________________________________

IN CASE OF EMERGENCY PLEASE NOTIFY:

Name _________________________________________

Address________________________________________

City _____________________State_____ Zip_________

Telephone (Day)_________________________________

Telephone (Eve) _________________________________

 

How did you first learn of Wilderness Photography Expeditions?

__________________________________________________


RELEASE AND ASSUMPTION OF RISK
         
I am aware that during the mountain tour, expedition, or other trip or vacation I am participating in under the arrangements of Wilderness Photography Expeditions and its agents and associates, certain risks and dangers may occur, including, but not limited to the hazards of traveling in mountainous terrain, illness or accident in remote places without medical facilities, the forces of nature, and travel by air, bus, automobile, or other means of transportation.

Signature___________________________________________

Date_______________________________________________

back

Home | Tours | Photography | Books & More


© 2019 Tom Murphy
Contact Tom Murphy