Deer Lodge Nature Center Girls' and Boys' Villages Pickett Dining Hall Open Air Gym Hainey Lodge Name of Group Date Contact Person Size of group 5 or less 5-25 25-50 50-75 75-125 125-200 More than 200 Address Afghanistan Albania Algeria Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Terr. Bonaire (Dutch Caribbean) Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Terr. Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Isl. & Mcdonald Isl. Vatican City State Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, D P R Korea, Republic of Kuwait Kyrgyzstan Lao People's D R Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, Former Y R of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, O Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent & Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia & S S Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States M O Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Phone Lodging Facilities Desired - Check all that apply Boys Village Cabins Girls Village Cabins Deer Lodge Room/s Hainey Lodge (Top) Hainey Lodge (Bottom) R.V Hookup Tents (specify number in comments) Add on Adventures + Horseback Riding Lifeguard Services Ski-Boat Rental Canoes Nature Center Zip Line Hay Ride Food Services Food Prepared by Cafeteria Number of Meals Number of Vegans Meeting Facilities Pickett Dining Hall Overlook Meeting Hall Deer Lodge Meeting Hall Hainey Lodge Upstairs Outdoor Gymnasium PLEASE SEND CHECK WITH $150.00 NON-REFUNDABLE DEPOSIT TO: TIMBER RIDGE CAMP IN ORDER TO CONFIRM RESERVATIONS. UNTIL THE DEPOSIT IS RECEIVED, NO WEEKEND WILL BE RESERVED. Type yes in field below to verify you have read this statement I HAVE READ THE CAMP POLICIES STATEMENT AND HAVE SUPPLIED COPIES OF “RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT” AND THE “EQUINE WAIVER AND RELEASE FORM” TO ALL PARTIES IN MY GROUP AND AGREE TO ABIDE BY SAID REGULATIONS. ALL SIGNED RELEASES MUST BE SUPPLIED TO TRC AND ADDENDUM TO USERS AGREEMENT MUST BE SIGNED UPON ARRIVAL - Type Yes in field Below Addition questions or Comments Submit
