| Wild River Country "Early Bird" Order Form |
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Please Print Legibly
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Order Season Passes
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| Individual Season Pass ($49.99+$4.56 tax=$54.55) | ______ | x | $54.55 | ______ |
| Family Season Pass for 3 ($119.99+$10.95 tax=$130.94) | ______ | x | $130.94 | ______ |
| Family Add-on ($49.99+$4.56 tax=$54.55) | ______ | x | $54.55 | ______ |
| Season Tube Rental ($20.00+$1.63 tax=$21.63) | ______ | x | $21.63 | ______ |
| (One tube per pass holder per visit.) | GRAND TOTAL | ______ | ||
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Please circle (T) by each name receiving a tube
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| Name of Pass Holder | ___________________________(T) | ___________________________(T) |
| Name of Pass Holder | ___________________________(T) | ___________________________(T) |
| Name of Pass Holder | ___________________________(T) | ___________________________(T) |
| Street Address ____________________________________________________________________________ | |||
| City ___________________ | State _____ | Zip ____________ | Phone # ______________ |
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PAYMENT
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[ ] Cash
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[
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| Please charge to my: |
[ ] Visa
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[ ] American
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Name On Card ___________________________________________________________
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Card number ___________________________ Expiration Date _____________________
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Signature ________________________________________________________________
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Order form must be received on or before APRIL 20, 2001
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MAIL TO:
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Wild River Country P.O. Box 1740 North Little Rock, AR 72115
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or FAX TO:
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(501) 753-0277
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or DELIVER TO:
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6820 Crystal Hill Road, North Little Rock, AR
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| back |
© 2001 Wild River Country - All Rights Reserved. |