Rough Country Outfitters and Guides, LLC

Rough Country Outfitters and Guides, LLC

P.O. Box 973, Glenrock, Wyoming 82637 Ph. (307) 436-2304 jimsrco@ HUNT BOOKING QUESTIONNAIRE

First Name: __________________________ Last Name: ______________________________ Initial: _______

Mail Address: ______________________ City: __________________ State: _______ Zip Code: ___________

Physical Address: ___________________________________________________________________________

Cell PH: _________________ Home PH: ____________________ E-mail: _____________________________

Height: _____ /______ Weight: ________ Hair: _________ Eyes: ________ D.O.B: ______ /______ /_______

(Mandatory) Last 4 digits of Soc. Sec. #: ____ /____ /____ /____ WGFD Sportsman ID #: _________________ __________________________________________________________________________________________

I wish to reserve a hunt with RCO, included is my Deposit Check for $1000.00, or charge to Credit Card below.

CC Info: VISA, MC, DISC. _______ /________ /________ /_______ Exp: ______ /______ Sec. Code: ______

I, _______________________ , Hereby authorize RCO to charge my Credit Card for Deposits, Payments or License Fees.

Desired Hunt: (#______ ) _____________________________________________ List Price: ______________

Preferred Dates: _________________________________________________________ Year: ______________

How many WGFD Preference Points do you currently have? Antelope: _______ Deer: _______ Elk: _______

How many people will be in your party: _______ Party Organizer: ____________________________________

An initial, non-refundable deposit/payment of $1,000.00 is required to reserve your hunt. A second payment totaling approximately 50% of the value of the hunt booked, plus WGFD License fees, will be due on or before January 1st, the year of your hunt. The final payment on your hunt will be due in full by August 15th. All reservations made after the WGFD draw will require a 50% deposit/payment at time of booking, with final payment due in full by August 15th. Personal or certified checks, money orders or credit cards are acceptable for all payments to RCO. A transaction fee of 4% will be added to all credit card payments. A Wyoming public lands use fee of $50.00, and a Wyoming sales and use tax of 10% will be charged on meals and lodging only, and is based on a daily rate of $100.00 per person, per day. No reservation is confirmed until Rough Country Outfitters and Guides, LLC, has received a full 50% deposit, completed booking contract, liability release and health & dietary questionnaire. All Hunt Reservation Deposits/Payments are non-refundable after January 1st, of the year the hunt is booked for, unless the booked guest can furnish RCO with an acceptable substitute for themselves. Beyond these terms, only upon failure to draw a license will any deposit/payment be returned, within 30 business days of the WGFD on-line drawing results. Withdrawn license applications do not constitute a failure to draw a license. We can make no refunds or adjustments for late arrivals, early departures, no-shows or late hunt cancellations. Likewise, the full contracted hunt fee is the responsibility of the booked client, and owed to the outfitter regardless of the clients participation in his or her booked hunt. Deposit/payments and/or licenses are not transferable to another person. Rough Country Outfitters and Guides, LLC, reserves the right to return deposits and/or hunt fees, and/or refuse service to anyone, at any time. The undersigned recognizes that there is an element of risk in any hunt, adventure, sport or activity associated with the great outdoors, and specifically assumes all risks and liability therein, pursuant to the Wyoming Recreation Safety Act [W.S.1-1-122,123], and is fully capable of participating in the above listed indoor/outdoor activity, hunt or trip. Therefore, holding harmless, James D. / Debra L. / and/or J. Dustin Schell, DBA Rough Country Outfitters and Guides, LLC., their agents, employees and/or landowner lessors, releasing them from all liabilities. Furthermore, the undersigned has read and fully understands and accepts the above terms and conditions of this contract, and willingly agrees to execute this contract by signing below, at his or her free will.

GUEST SIGNATURE: _______________________________________________________________ Date: _________ /_________ /___________

Rough Country Out tters and Guides, LLC, are fully licensed, Insured, Authorized and permitted to operate on the North & South Medicine Bow / Routt National Forests, BLM, State of Wyoming Lands, and Leased Private Lands. RCO is a proud equal opportunity service provider & employer. (JIM SCHELL, WYOMING BIG GAME OUTFITTERS'S LICENSE #BG-207). PLEASE RETAIN A COPY OF THIS BOOKING CONTRACT FOR YOUR PERSONAL RECORDS

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