Fishing Application
Please print out this entire page to fill out your application.
(use printing options 'Only the selected frame' or 'All frames individually )
Date of Application____________
PowderKegg Wildlife Preserve, LLC
1390 Oakland School Road
Cassatt, South Carolina 29032
(803) 432-1386 [fax # is same; please call before faxing]
www.powderkegg.org
jeanie@powderkegg.com
“Fishing Application"
between Outfitter-Powderkegg & Fishing Guest
(Note: Each guest must complete a separate application.
This application applies to all future fishing for the guest.)
Type of Fishing (circle one): `Catch & Release' `Catch & Keep'
Date requested for your fishing____/____/____ # Hours of Fishing________
Start Time:__________ End Time:________
('check', if applies) 1st Timer Special?______ `Bring a Guest' Special?_______
Overnight Special Package_______________________________________
Dates requested for your fishing trip:____/____/____to____/____/____
# of Adult Guests: ________ # of Guests Under Age 12 _____ (Name__________________)
Name First__________________________Middle___________Last____________________
Address:______________________City_________________State___________Zip_________
Phone#: Home___________________Work__________________Cell____________________
E-mail:______________________________________________________Other____________
Date of Birth_____/____/____
Drivers License #:_________________State________
Method of Payment (circle one): Cash Check Money Order [Make payable to
PowderKegg Wildlife Preserve, LLC] For the Rules & Rates of fishing, see the
- PowderKegg (outfitter) accepts only a limited number of guests on its `fishing special packages' on a first come, first serve basis.
Therefore, it is important that openings during the fish season are filled and do not go unused due to cancellations. For this reason,
the deposit for fishing special packages is nonrefundable if the guest cancels the fishing special package. If for some reason
the Outfitter cancels the fishing special package, the deposit will be refunded.
- The Outfitter reserves the right to use any photographs, video footage, fishing stories and names for marketing purposes,
business enhancing opportunities, and/or profitable strategies for Powderkegg Wildlife Preserve. Successful guests are
required to deliver to the outfitter copies of photos of film footage taken of their trophy fish.
- The Outfitter uses its best efforts to provide the guest with a safe and enjoyable fishing. However, it is the responsibility of the guest to
exercise care and judgment required to deal with the dangers and risk inherent in the sport of fishing. 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
of 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 fishing 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 fishing 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.
- I, the guest, accept full responsibility for any injury I, the guest, may incur while fishing with PowderKegg Wildlife Preserve (Outfitter). I, the
guest, will follow the rules and will take all safety precautions around all ponds and will supervise any guests accompanying me while fishing.
I, the guest, will provide all my fishing equipment (rods, reels, tackle, buckets, bait, coolers, etc.) and accept full responsibility for them.
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, the guest (Fisherman) have read the above contract and agree to abide by statements in the
waiver, to abide by the rules and understand that my fishing times start and end at the Lodge.
I agree to pay all fishing fees before I start fishing by going first to Lodge to check in.
I agree to meet back at the Lodge when I finish fishing to check out and to give my fishing
report to Outfitter. I also agree to pay all fishing fees incurred beyond original set times
before departing from the Wildlife Preserve property.
Fisherman Printed Name
Name____________________________________________________________________
Fisherman Signature
NameX_____________________________________________ Date_____/_____/________
Return Contract to:
Powderkegg Wildlife Preserve
1390 Oakland School Road
Cassatt, South Carolina 29032
