2002 POTTER’S RANCH GUEST WORKSHEET (RETURN)

DATE ______________________________

NAME OF GROUP ____________________________________________ DATE(S) DESIRED ___________________________

GROUP SIZE ___________________________________________ DESIRED ARRIVAL TIME __________________________

AGES _________________________________________________ DESIRED DEPARTURE TIME _______________________

GROUP LEADER _______________________________________ HOME PHONE ____________________________________

ADDRESS ____________________________________________   WORK PHONE ____________________________________

CITY __________________________________________________ STATE ________________________ ZIP ______________

SERVICE REQUEST:  PLEASE CIRCLE OR PRINT ALL OF YOUR NEEDS

q              CORPORATE TEAM BUILDING PROGRAM  q ONE DAY q TWO DAYS
PACKAGE RATES APPLY TO A GROUP SIZE OF 24 OR MORE. PRICES ARE ALACARTE FOR LESS THAN 24.
q              CEDAR CABIN PACKAGE (includes 3 meals - BL&D, 1 night’s lodging, use of fellowship hall & beverage bar)
q              PIONEER VILLAGE PACKAGE (includes 3 meals - BL&D, 1 night’s lodging, use of lower level & beverage bar)

q  ð                    MEALS:  (Minimum group size of 10 at Lodge Village and 20 at Pioneer Village)
ðq                     (Pricing on menu selection) Circle meals wanted under day of the week.
                MONDAY               TUESDAY                  WEDNESDAY                THURSDAY           FRIDAY        SATURDAY
                B   L   D                       B    L    D                   B    L    D                          B    L    D                 B   L    D          B    L    D
                Breakfast & Lunch are served at a fixed time of 8:00 am & 12:00 noon                        Evening Dinner Meal Time: ________________
q             SNACK(S)  q   BEV. BAR SERVICE (UP TO 4 HRS.)  q  BEV. BAR SERVICE (UP TO 8 HRS.)  q  ENTIRE STAY    

q
             LODGE/FELLOWSHIP HALL
               EQUIPMENT DESIRED                                __________________________________________________________________________________________________

q
           CABINS:  FOUR CABINS ARE AVAILABLE. EACH CABIN IS A 3 BEDROOM/3 BATHROOM FACILITY WITH FULL KITCHEN AND LIVING ROOM., (TWO PEOPLE PER BEDROOM/SIX PEOPLE PER CABIN)

                CABINS DESIRED:                                             CABIN                   CABIN                   CABIN                   CABIN
                BEDROOMS DESIRED:                                      1     2    3                1    2    3                  1    2    3                  1    2    3
                DAY RENTAL/NIGHT RENTAL
                (CHECK-IN - 4:00 PM / CHECK-OUT - 12:00 NOON)

q
             TIPI VILLAGE:
                DAY RENTAL/ NIGHT RENTAL                                               DESIRED ARRIVAL TIME ________________________
                # PEOPLE _____________________________                         DESIRED  DEPARTURE TIME _____________________

                18’ TIPI’S (NUMBER)                            1                2                3                4                5                6                7                8
                26’ COUNCIL TIPI                     YES                         NO

q             TRAIL RIDES:   # OF PEOPLE __________                DATE: ________________         TIME: ___________________
q             WAGON RIDES: # OF PEOPLE _________                DATE: ________________         TIME: ___________________
q             SHADY GROVE PICNIC AREA:
                # PEOPLE _____________________________                         DESIRED ARRIVAL TIME ________________________
                                                                                                                                DESIRED DEPARTURE TIME _____________________
q            HAYRIDE:
                # PEOPLE _____________________________                         DESIRED ARRIVAL TIME ________________________
                                                                                                                                DESIRED DEPARTURE TIME _____________________

q            BONFIRE              WE BUILD – COST IS $10.00                DATE/TIME ______________              YOU BUILD – NO CHARGE
q             LOW RCC                LOW/HIGH RCC                TOWER OF POWER                          ZIP LINE
                # _______                #______________               # _________________                     #_________

q             OTHER NEEDS:  (PLEASE SPECIFY) ________________________________________________________________

guest.wks

2/14/02