Take A Soldier Fishing - Lake Sam Rayburn - 03/27/10 - BOATER
Please fill out the form completely. Contact information is provided to keep you updated of any changes that may occur to the scheduled event.
Name:
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Email Address:
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Phone Number:
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Mailing Address:
Emergency Contact Information:
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Do you have insurance?
Yes
No
Does your boat have wheelchair accessibility?
Yes
No
How many soldiers can you take on your boat?
Questions/Comments?
I agree to the following:
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Waiver of Liability/Hold Harmless Agreement
Abide by ALL laws and regulations
No alcohol / drugs during activities
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