Print this form and mail it to: Wild River Country - P.O. Box 1740 - North Little Rock, AR 72115

Season Pass Order Form
This Form Must Be Legibly Completed In Order To Be Processed. Please Print.
PS
Office Use Only: Certificate# Date: Initials

Family Season Pass for 3 Please Print Legibly
Age
Birthday
Name of Pass User___________________________________ ___ ___/___/___
Name of Pass User___________________________________ ___ ___/___/___
Name of Pass User___________________________________ ___ ___/___/___
Street Address__________________________________________________________
City____________________State_________ZIP_________Phone ( ___)____________
ADDITIONAL FAMILY MEMBERS to be added to our season pass Age Birthday
Name of Add'l User___________________________________ ___ ___/___/___
Name of Add'l User___________________________________ ___ ___/___/___
Name of Add'l User___________________________________ ___ ___/___/___


Individual Season Pass Please Print Legibly
Age
Birthday
Name of Pass User___________________________________ ___ ___/___/___
Name of Pass User___________________________________ ___ ___/___/___
Name of Pass User___________________________________ ___ ___/___/___
Street Address__________________________________________________________
City____________________State_________ZIP_________Phone ( ___)____________
For additional Individual Passes, please attach a separate piece of paper

Ordering Information Please Print Legibly
Remember, children 2 and younger are FREE!
 
Family Passes For 3 (Covers 3 related persons living in the same household)
Please send a Wild River Country Family Season Pass at $169.99 + 12.96 tax = $182.95 = $ ________
Plus _______ additional family members at $49.99 each plus 3.81 tax = $53.80 = $ ________

Individual Passes
_____ $69.99 Individual Season Pass(es) (Covers all ages) + 5.34 tax = $75.33 = $ ________

Tube Rental Add-on
_______ $20.00 Per add-on (one tube er visit) + 1.33 tax = $21.33 = $ ________

 
Enclosed is my check / money order for $ ________

Please Charge to My:
[ ] Visa
[ ] MasterCard
[ ] American Express
 
Card number ___________________________ Expiration Date _____________________
 
Signature ________________________________________________________________

Print this form and mail it to: Wild River Country - PO Box 1740 - North Little Rock, AR 72115

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