Lodging Application

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" height=90 BGCOLOR="#006699" TEXT="#080000" bgproperties="fixed" background="02c285a1erlcgo.png"> <div> <FONT SIZE="5" COLOR="#FFCC66" FACE="Arial" ><B>PowderKegg Wildlife Preserve Trophy Fishing & Event Site Rental</B></FONT><B>    </B><B> |     </B><A HREF="index.htm" TARGET="_top" TITLE="PowderKegg Wildlife Preserve Trophy Fish"><U><B>home</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE=" Retreat Lodging"><U> Retreat Lodging</U></A>   |   <B>Lodging Application</B></div> <div> </div> </td> </tr><tr> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Lodging Application</I></div> <div> <I><B>Return to </B></I><A HREF="id37.htm" TARGET="_top" TITLE="Fishing Overnight Specials"><U><I><B>Fishing Overnight Specials</B></I></U></A></div> <DIV ALIGN="LEFT"></DIV> <div> <B>PowderKegg Wildlife Preserve, LLC</B></div> <div> 1390 Oakland School Road</div> <div> Cassatt, South Carolina  29032</div> <div> <B>(</B><FONT SIZE="4" COLOR="#000000" FACE="Arial" ><B>803) 432-1386 </B></FONT><B>  </B><FONT SIZE="1" COLOR="#000000" FACE="Arial" ><B> </B></FONT><FONT SIZE="1" COLOR="#111111" FACE="Arial" >[fax #  is same; please call before faxing]</FONT></div> <div> www.powderkegg.com    &    <A HREF="http://www.powderkegg.org" TARGET="_top" TITLE="http://www.powderkegg.org"><U><U>www.powderkegg.org</U></U></A></div> <bR> <div> <B>“Lodging”</B> (check in 5pm, check out 2pm)</div> <div> <B>Date of Application</B>_________________</div> <bR> <div> <B>Name: </B>First__________________________Middle___________Last__________________________</div> <bR> <div> <B>Address:</B>___________________________City_________________State___________Zip_________</div> <bR> <div> <B>Phone</B>#:<B> </B>Home___________________Work__________________Cell_________________________</div> <bR> <div> <B>E-mail:</B>________________________________________________________________________</div> <bR> <div> Date of Birth_____/____/____Drivers License #:_________________State_____________________</div> <bR> <div> Dates for Lodging:____/____/____to____/____/____ <FONT SIZE="2" COLOR="#000000" FACE="Arial" > # of Individuals ________Total Due:_______________               </FONT></div> <div> # of Families________ Total Due:_______________</div> <div> <B>Special</B>_______________________________Deposit:____________Total Due Upon Arrival:____________________</div> <div> <FONT SIZE="3" COLOR="#000000" FACE="Arial" ><B>Meals</B>:</FONT> # of <I>Adult</I> meals 10am ____ 8pm____, # of <I>under age 12</I> meals 10am____ 8pm____ Total Due for Meals :______________ </div> <div> <FONT SIZE="3" COLOR="#000000" FACE="Arial" ><U>Method of Payment</U> </FONT><FONT SIZE="2" COLOR="#000000" FACE="Arial" >(circle one)</FONT><FONT SIZE="3" COLOR="#000000" FACE="Arial" >:  Cash     Check     Money Order </FONT>  [Make payable to: <B>PowderKegg Wildlife Preserve, LLC</B>]  <FONT SIZE="3" COLOR="#000000" FACE="Arial" >   </FONT></div> <div> <FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT><B>Activities:</B>  <U>For the Costs of Riding/Lessons</U>, see the `<A HREF="id19.htm" TARGET="_top" TITLE="Horse Stable"><U>Horse Stable</U></A>' page at www.powderkegg.org  </div> <div> <U>For the Costs, Limits & Rules of Fishing</U>, see `<A HREF="id18.htm" TARGET="_top" TITLE="Fishing (Specials, Reports)"><U>Fishing(Specials & Reports</U></A>)' page at www.powderkegg.org</div> <bR> <div> The Outfitter reserves the right to use any photographs, video footage, hunt stories, fishing stories, riding stories and names for marketing purposes, business enhancing opportunities, and/or profitable strategies for Powderkegg Wildlife Preserve. </div> <div>       The Outfitter uses its best efforts to provide the guest with a safe and enjoyable experience.  However, it is the responsibility of the guest to exercise care and judgment required to deal with the dangers and risk inherent in the sports chosen.  Therefore, the guest releases and forever discharges, and for his/her heirs, executors, administrators, personal representatives, successors, and assigns to hereby release and forever discharge the Outfitter (Powderkegg Wildlife Preserve) and his or her, their and its successors and assigns, heirs and executors, administrators, personal representatives, and all other persons, firms and businesses, of any claims, demands, rights, and causes of actions fo whatsoever kind and nature, arising from, and by reason of any of all known and unknown, foreseen and unforeseen bodily and personal injuries, damage to property, and the consequences thereof, resulting, and the result, from the guest's activities on the dates written in this contract.  Additionally, the guests agree to defend any or all individuals in civil court against injury, property or punitive damage caused by the guest while engaged in activities with the Outfitter.  If I, the guest, sue any and all individuals in civil court and win a settlement, I, the guest, relinquish all rights to receive that settlement from any of the aforementioned individuals.</div> <div>      I, the guest, accept full responsibility for any injury I, the guest, may incur while engaged in activities with Powderkegg Wildlife Preserve (Outfitter).  I, the guest, will inspect the safety of any equipment used. </div> <div> <I>     The requirements for enjoying the sports of PowderKegg Wildlife Preserve have been developed with careful consideration for the convenience of the guest and for the maintenance and protection of the Preserve's grounds and  Lodge.  We ask your cooperation in helping us maintain the Preserve.</I></div> <bR> <div> I, the guest (Guest and/or Rider/Fisher/Hunter) have read the above contract and agree to abide by statements in the waiver and to pay all fees incurred before departing from the Wildlife Preserve property.  I will also complete Application forms for the particular activity chosen (i.e., Riding and/or Riding Lesson, Hunting and/or Fishing Application)</div> <bR> <div> Guest <B>Printed Name</B>________________________________________________________________</div> <bR> <div> Guest <B>Signature </B>Name:  <FONT SIZE="4" COLOR="#000000" FACE="Arial" ><B>X</B></FONT>___________________________________________________________ </div> <div> Date_____/_____/________</div> <bR> <div> Return Contract to:<FONT SIZE="4" COLOR="#000000" FACE="Arial" > Powderkegg Wildlife Preserve</FONT></div> <div> 1390 Oakland School Road</div> <div> Cassatt, South Carolina 29032<FONT SIZE="3" COLOR="#000000" FACE="Arial" ><B> </B></FONT></div> <bR> <div> Warning:  Under South Carolina law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in an equine activity resulting from an inherent risk of equine activity, pursuant to Article 7, Chapter 9 of Title 47, Code of Laws of South Carolina, 1976</div> <bR> </td> </tr></table></body>