Pack Shack Adventures, Inc.
P.O. Box 127, 88 Broad Street
Delaware Water Gap, PA. 18327
Activity: _____________________________________________________________
Name of Organization: ________________________________________________
Address: _____________________________________________________________
City: ___________________ State_____________ Zip____________________
Group Advisor or Leader: _____________________________________________
Address: _____________________________________________________________
City: ___________________ State_____________ Zip____________________
Phone (with area code): ______________________________________________
We would like to make a reservation for _________ people which includes:
_______ Scouts, _______ Leaders OR _________ Youth _________ Leaders
Is your group coed? _________ Yes _________ No
Our Reservation Deposit of $50.00 per person is enclosed.
Total amount enclosed is $___________________
The Dates we are requesting are:
1st Choice: _________________ to _______________________.
2nd Choice: _________________ to _______________________.
Which airport is most convienient for your group to fly out of?
_______________________________________________________________________.
Does your group have any special needs?
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