Rustic Ridge Resort

Applicant

Name:*

First

Last

Date of Birth*

Drivers License Number*

Phone:*

Area Code

Phone Number

E-mail:*

Address:*

Street AddressCityState / Province / RegionPostal / Zip Code

Spouse

Spouse Name:

First

Last

Spouse Date of Birth

Spouse Drivers License Number

Spouse Phone:

Area Code

Phone Number

Spouse E-mail:

Spouse Address: (if different from above)

Street AddressStreet Address Line 2CityState / Province / RegionPostal / Zip Code

Additional Occupants

Name (Occ 1)

First

Last

Date of Birth (Occ 1)

Relationship (Occ 1)

Name(Occ 2)

First

Last

Date of Birth(Occ 2)

Relationship(Occ 2)

Name: (Occ 3)

First

Last

Date of Birth (Occ 3)

Relationship (Occ 3)

Name: (Occ 4)

First

Last

Date of Birth: (Occ 4)

Relationship: (Occ 4)

Vehicles
RV

Yr.*

Length*

Make/Model*

Color:*

State*

License No.*

RV Registered Owner*

Vehicle 1

Yr.(Veh1)*

Make/Model(1)*

Color:(1)*

State(1)*

License No.(1)*

Vehicle 2

Yr.(Veh2)

Make/Model(2)

Color:(2)

State(2)

License No.(2)

Pets

Type (Pet1)

Breed: (Pet1)

Pet Color: (Pet1)

Age: (Pet1)

Weight: (Pet1)

Pet License No. (Pet1)

Pet Name: (Pet1)

Emergency Contact

Contact Name:*

First

Last

Contact Phone:*

Area Code

Phone Number

Contact Relationship:*

Signature*

Date*

Word Verification:

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< SUBMIT APPLICATION NOW and we will contact you to discuss your desired site.*Filling out this application does not commit you as a camper, it just makes the process faster once desired site availability is confirmed.