River Rage

River Rage Gauley '10

Name:_______________________________________

Phone Number:________________________________

Email Address: ________________________________

			Total
Upper Gauley Rafting Package	Rafting, 2 Nights Camping, Meals, Parties, Prizes	_____ @ $200
Lower Gauley Rafting Package	Rafting, 2 Nights Camping, Meals, Parties, Prizes	_____ @ $180

Extra Nights Camping	Thurs	_____ @ $8

	Total:

*Please list all attendees, amount paid, and email if paying for more then 1 person: (i.e. Jan Brady-$186 jan@aol.com) Thanks!

____________________________________________________________________________________________________

MAIL IN THIS FORM and make Checks Payable To:

Paddles, Poles & More, Inc.
11128 Sedgemoor Lane
Charlotte, NC 28277