*FOR OFFICE USE ONLY*

RESERVATION NAME ______________________

DATE _____/_____/_____TIME_______________

CHECK
HERE

APPROX. PRICE PER PRICE PER

LAST
MILES HOURS
CANOE
KAYAK LAUNCH TIME

TRIP
FACTORY TO
IRON CITY

3-4

$35

$25

2 PM

BUSBY TO
IRON CITY

10

5-6

$40

$30

12 PM

________ Number of Kayaks

IRON CITY TO
GOOSE SHOALS

10

5-6

$40

$30

12 PM

________ Number of Tubes

FACTORY TO
GOOSE SHOALS

18

8-10

$55

$35

7 AM

________ Number of Shuttles

BUSBY TO
GOOSE SHOALS

20

10-12

$60

$40

7 AM

2 DAY

$65

$45

Camping? Dates ____/____/____ to ____/____/____

3 DAY

$95

$65

BY LAW, KIDS 12 & UNDER MUST WEAR LIFE VEST

4 DAY

$125

$85

________ Number of Canoes

(2 SEATS PER CANOE - 3rd PERSON 13 & OLDER PAYS $5 EXTRA)

________ TOTAL NO. OF PEOPLE

SHOAL CREEK CANOE RUN

RENTAL AGREEMENT & RELEASE FROM LIABILITY

In consideration of SHOAL CREEK CANOE RUN (furthermore known as SCCR) leasing equipment (i.e., canoe, kayak, tube, life vest, paddle) to me and providing shuttle service to and/or from th
will be responsible and abide by the rules posted. I fully understand the safe operation of the leased equipment from SCCR and I agree to observe all safety precautions in the use of said equipm
is not a manufacturer of leased equipment and has not made and does not make any resolutions, warranty or covenants, expressed or implied, with respect to the condition, quality, durability or su
the leased equipment. I agree and understand that all rental fees are for the leased equipment AND any transportation to and from the site is a gratuitous and incidental service of SCCR and is
optional. I am aware and agree that in the case of inclement weather and I am on the creek, I will not be refunded any fees paid for leased equipment. I also understand that if there is any loss or
the leased equipment, truck or trailer, accidental or not, I will be liable for costs of replacement or repair. I have examined the equipment I have leased from SCCR and find it to be in a safe con
repair and agree to return said equipment in the same condition. I am aware that canoeing is a dangerous activity; therefore, I will wear my life vest at all times and canoe responsibly. I agree tha
children 12 and under shall wear their life vest at ALL times while on the creek. I will abstain from using intoxicants and/or drugs while on the creek. I understand that in the event of injury or death
trip (while being shuttled or on the creek), SCCR owners and employees are not responsible and carry no medical insurance of any kind on myself and/or my passengers. I, on behalf of myself, m
representatives and my heirs hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify SCCR and its owners, agents, officers, and employees from any and al
actions, or losses for bodily injury, property damage, wrongful death, loss of services, or otherwise which may arise out of my use of equipment or my participation in canoeing, kayaking and/or
specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents,
employees of SCCR. I have read the above risk and waiver agreement and by signing below I agree it is my intention to exempt and relieve SCCR from liability for personal injury, p
damage or wrongful death caused by negligence or any other cause.
Also by signing, I agree to reimbursing Shoal Creek Canoe Run the cost of equipment if lost or damaged:
Canoe - $900.00 each - Kayak - $350.00 each - Tube - $40.00 each - Canoe Paddle - $15.00 each - Kayak Paddle - $30.00 - Life Vest - $10.00 each

SHOAL CREEK CANOE RUN IS NOT RESPONSIBLE FOR ACCIDENTS

PLEASE FILL OUT ONE FORM PER

GROUP
Responsible Person in Party

BY SIGNING, YOU AGREE TO AND ARE BOUND BY THE TERMS ABO

Other Participants Sign Below and on Bac

Adults Sign for those 18 and Under.

1 _________________________________________________

NAME (PLEASE PRINT)____________________________

2 __________________________________________________

3 __________________________________________________

4 __________________________________________________

ADDRESS____________________________________

5 __________________________________________________

6 __________________________________________________

7 __________________________________________________

ADDRESS____________________________________

5 __________________________________________________

6 __________________________________________________

CITY_______________________STATE_____ZIP___________

7 __________________________________________________

8 __________________________________________________

9 __________________________________________________

CELL PHONE__________________________________

10 _________________________________________________

11 _________________________________________________

HOME PHONE_________________________________
DRIVER'S LICENSE NO.__________________________

BY SIGNING, YOU AGREE TO AND ARE BOUND BY THE TERMS ABOVE.

SIGNATURE_____________________________________
_

TURN PAGE OVER FOR MORE SIGNATURES

HOME PHONE_________________________________
DRIVER'S LICENSE NO.__________________________

EVERY PERSON NEEDS TO SIGN. ADULTS SIGN FOR CHILDREN UNDER 18. BY SIGNING YOU AGREE TO AND ARE BOUND BY TERMS ON REVER

12 __________________________________________________

51 ___________________________________________

13 __________________________________________________

52 ___________________________________________

BY SIGNING, YOU AGREE TO AND ARE BOUND BY THE TERMS ABOVE.

SIGNATURE_____________________________________
14 __________________________________________________
_

53 ___________________________________________

15 __________________________________________________

54 ___________________________________________

16 __________________________________________________

55 ___________________________________________

17 __________________________________________________

56 ___________________________________________

18 __________________________________________________

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19 __________________________________________________

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60 ___________________________________________

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61 ___________________________________________

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62 ___________________________________________

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26 __________________________________________________

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29 __________________________________________________

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44 __________________________________________________

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87 ___________________________________________

49 __________________________________________________

88 ___________________________________________

50 __________________________________________________

89 ___________________________________________

NLY*
PICKUP TIME

service to and/or from the creek, I

n the use of said equipment. SCCR
on, quality, durability or suitability of
al service of SCCR and is solely
hat if there is any loss or damage to
find it to be in a safe condition of
e responsibly. I agree that by law,
e event of injury or death during this
I, on behalf of myself, my personal
mployees from any and all claims,
noeing, kayaking and/or tubing. I
t by the owners, agents, officers or
ty for personal injury, property

$10.00 each

BY THE TERMS ABOVE.

w and on Back.
and Under.

________________

________________

_______________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

GNATURES

TERMS ON REVERSE.

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

________________________

SCCR Camping Rules and Regulations

NAME
1.Campers please dispose of all garbage in dumpster.
_____________________
TODAYS DATE
Leave your campsite clean and litter-free!
______/______/______
2.Quiet time is 10:00 PM 6 AM.
DATES OF
3.Pets are to be restrained at all times and owners
RESERVATIONS:
must clean up after pets.
______/______/______
4.You are responsible for keeping your fire under TO
control at all times. Please make sure fire is extinguished______/______/______
CAMPSITE NUMBER
before leaving campsite.
_____________

SCCR Camping Rules and Regulations

NAME
1.Campers please dispose of all garbage in dumpster.
_____________________
TODAYS DATE
Leave your campsite clean and litter-free!
______/______/______
2.Quiet time is 10:00 PM 6 AM.
DATES OF
3.Pets are to be restrained at all times and owners
RESERVATIONS:
must clean up after pets.
______/______/______
4.You are responsible for keeping your fire under TO
______/______/______
control at all times. Please make sure fire is extinguished
CAMPSITE NUMBER
before leaving campsite.
_____________

habitat the way you found it. Only dead and down wood may be used for campfires.

habitat the way you found it. Only dead and down wood may be used for campfires.

6.Please respect other campers campsites and belongings.

6.Please respect other campers campsites and belongings.

Do not trespass on other campsites. If you witness any act of vandalism

Do not trespass on other campsites. If you witness any act of vandalism

5.

Do not cut down, carve into or damage any live trees. Please leave the natural

5.

Do not cut down, carve into or damage any live trees. Please leave the natural

to any campsite or vehicles, please report it to the management immediately.

to any campsite or vehicles, please report it to the management immediately.

7.No fighting or boisterous behavior. Keep noise to a minimum to respect

7.No fighting or boisterous behavior. Keep noise to a minimum to respect

other campers. No amplified music allowed.

other campers. No amplified music allowed.

8.Zero tolerance on nudity, public intoxication, and any other unlawful or

8.Zero tolerance on nudity, public intoxication, and any other unlawful or

disrupting behavior.

disrupting behavior.

9.No firearms, fireworks or explosives of any kind are allowed on the premises.

9.No firearms, fireworks or explosives of any kind are allowed on the premises.

10.Use cars, bikes, 4-wheelers or other such vehicles to enter or exit the

10.Use cars, bikes, 4-wheelers or other such vehicles to enter or exit the

campsite area only.

campsite area only.

11.Illegal drugs are prohibited on campsite at all times.

11.Illegal drugs are prohibited on campsite at all times.

12.Campers will not be refunded due to inclement weather.

12.Campers will not be refunded due to inclement weather.

13.Check in time is 2 PM. Check out time is 1 PM.

13.Check in time is 2 PM. Check out time is 1 PM.

14.Children must be supervised at all times. DO NOT leave them unattended.

14.Children must be supervised at all times. DO NOT leave them unattended.

Shoal Creek Canoe Run owners and employees reserve the right to remove anyone from

Shoal Creek Canoe Run owners and employees reserve the right to remove anyone from

the premises that will not abide by the rules and regulations.

SCCR Camping Rules and Regulations

NAME
1.Campers please dispose of all garbage in dumpster.
_____________________
TODAYS DATE
Leave your campsite clean and litter-free!
______/______/______
2.Quiet time is 10:00 PM 6 AM.
DATES OF
3.Pets are to be restrained at all times and owners
RESERVATIONS:
must clean up after pets.
______/______/______ TO
4.You are responsible for keeping your fire under
______/______/______
CAMPSITE NUMBER
control at all times. Please make sure fire is extinguished
_____________
before leaving campsite.
5.

Do not cut down, carve into or damage any live trees. Please leave the natural

the premises that will not abide by the rules and regulations.

SCCR Camping Rules and Regulations

NAME
1.Campers please dispose of all garbage in dumpster.
_____________________
TODAYS DATE
Leave your campsite clean and litter-free!
______/______/______
2.Quiet time is 10:00 PM 6 AM.
DATES OF
3.Pets are to be restrained at all times and owners
RESERVATIONS:
must clean up after pets.
______/______/______
4.You are responsible for keeping your fire under TO
______/______/______
control at all times. Please make sure fire is extinguished
CAMPSITE NUMBER
before leaving campsite.
_____________
5.

Do not cut down, carve into or damage any live trees. Please leave the natural

habitat the way you found it. Only dead and down wood may be used for campfires.

habitat the way you found it. Only dead and down wood may be used for campfires.

6.Please respect other campers campsites and belongings.

6.Please respect other campers campsites and belongings.

Do not trespass on other campsites. If you witness any act of vandalism

Do not trespass on other campsites. If you witness any act of vandalism

to any campsite or vehicles, please report it to the management immediately.

to any campsite or vehicles, please report it to the management immediately.

7.No fighting or boisterous behavior. Keep noise to a minimum to respect

7.No fighting or boisterous behavior. Keep noise to a minimum to respect

other campers. No amplified music allowed.

other campers. No amplified music allowed.

8.Zero tolerance on nudity, public intoxication, and any other unlawful or

8.Zero tolerance on nudity, public intoxication, and any other unlawful or

disrupting behavior.

disrupting behavior.

9.No firearms, fireworks or explosives of any kind are allowed on the premises.

9.No firearms, fireworks or explosives of any kind are allowed on the premises.

10.Use cars, bikes, 4-wheelers or other such vehicles to enter or exit the

10.Use cars, bikes, 4-wheelers or other such vehicles to enter or exit the

campsite area only.

campsite area only.

11.Illegal drugs are prohibited on campsite at all times.

11.Illegal drugs are prohibited on campsite at all times.

12.Campers will not be refunded due to inclement weather.

12.Campers will not be refunded due to inclement weather.

13.Check in time is 2 PM. Check out time is 1 PM.

13.Check in time is 2 PM. Check out time is 1 PM.

14.Children must be supervised at all times. DO NOT leave them unattended.

14.Children must be supervised at all times. DO NOT leave them unattended.

Shoal Creek Canoe Run owners and employees reserve the right to remove anyone from

Shoal Creek Canoe Run owners and employees reserve the right to remove anyone from

the premises that will not abide by the rules and regulations.

the premises that will not abide by the rules and regulations.

DATE ________/________/________ TIME _____________________

DATE ________/________/________ TIME _____________________

PARTY NAME _____________________________

PARTY NAME _____________________________

NO. IN PARTY _______________

NO. IN PARTY _______________

CANOE #'S

CANOE #'S

TRIP ____________________

TRIP ____________________

________CANOES

________CANOES

________KAYAKS

________KAYAKS

________TUBES

________TUBES

________SHUTTLES

________SHUTTLES

________PADDLES

________PADDLES

________LIFE VESTS (ADULTS)

________LIFE VESTS (ADULTS)

________LIFE VESTS (KIDS)

________LIFE VESTS (KIDS)

DATE ________/________/________ TIME _____________________

DATE ________/________/________ TIME _____________________

PARTY NAME _____________________________

PARTY NAME _____________________________

NO. IN PARTY _______________

NO. IN PARTY _______________

CANOE #'S

TRIP ____________________

TRIP ____________________

________CANOES

________CANOES

________KAYAKS

________KAYAKS

________TUBES

________TUBES

________SHUTTLES

________SHUTTLES

________PADDLES

________PADDLES

________LIFE VESTS (ADULTS)

________LIFE VESTS (ADULTS)

________LIFE VESTS (KIDS)

________LIFE VESTS (KIDS)

NAME
_____________________
TODAYS DATE
______/______/______
DATES OF
RESERVATIONS:
______/______/______

CANOE #'S

NAME
_____________________
TODAYS DATE
______/______/______
DATES OF
RESERVATIONS:
______/______/______

SCCR Camping Rules and Regulations

NAME
1.Campers please dispose of all garbage in dumpster.
_____________________
TODAYS DATE
Leave your campsite clean and litter-free!
______/______/______
2.Quiet time is 10:00 PM 6 AM.
DATES OF
3.Pets are to be restrained at all times and owners
RESERVATIONS:
must clean up after pets.
______/______/______
4.You are responsible for keeping your fire under TO
control at all times. Please make sure fire is extinguished______/______/______
CAMPSITE NUMBER
before leaving campsite.
_____________

SCCR Camping Rules and Regulations

NAME
1.Campers please dispose of all garbage in dumpster.
_____________________
TODAYS DATE
Leave your campsite clean and litter-free!
______/______/______
2.Quiet time is 10:00 PM 6 AM.
DATES OF
3.Pets are to be restrained at all times and owners
RESERVATIONS:
must clean up after pets.
______/______/______
4.You are responsible for keeping your fire under TO
control at all times. Please make sure fire is extinguished ______/______/______
CAMPSITE NUMBER
before leaving campsite.
_____________

5.

5.

Do not cut down, carve into or damage any live trees. Please leave the natural

Do not cut down, carve into or damage any live trees. Please leave the natural

habitat the way you found it. Only dead and down wood may be used for campfires.

habitat the way you found it. Only dead and down wood may be used for campfires.

6.Please respect other campers campsites and belongings.

6.Please respect other campers campsites and belongings.

Do not trespass on other campsites. If you witness any act of vandalism

Do not trespass on other campsites. If you witness any act of vandalism

to any campsite or vehicles, please report it to the management immediately.

to any campsite or vehicles, please report it to the management immediately.

7.No fighting or boisterous behavior. Keep noise to a minimum to respect

7.No fighting or boisterous behavior. Keep noise to a minimum to respect

other campers. No amplified music allowed.

other campers. No amplified music allowed.

8.Zero tolerance on nudity, public intoxication, and any other unlawful or

8.Zero tolerance on nudity, public intoxication, and any other unlawful or

disrupting behavior.

disrupting behavior.

9.No firearms, fireworks or explosives of any kind are allowed on the premises.

9.No firearms, fireworks or explosives of any kind are allowed on the premises.

10.Use cars, bikes, 4-wheelers or other such vehicles to enter or exit the

10.Use cars, bikes, 4-wheelers or other such vehicles to enter or exit the

campsite area only.

campsite area only.

11.Illegal drugs are prohibited on campsite at all times.

11.Illegal drugs are prohibited on campsite at all times.

12.Campers will not be refunded due to inclement weather.

12.Campers will not be refunded due to inclement weather.

13.Check in time is 2 PM. Check out time is 1 PM.

13.Check in time is 2 PM. Check out time is 1 PM.

14.Children must be supervised at all times. DO NOT leave them unattended.

14.Children must be supervised at all times. DO NOT leave them unattended.

Shoal Creek Canoe Run owners and employees reserve the right to remove anyone from

Shoal Creek Canoe Run owners and employees reserve the right to remove anyone from

the premises that will not abide by the rules and regulations.

SCCR Camping Rules and Regulations

NAME
1.Campers please dispose of all garbage in dumpster.
_____________________
TODAYS DATE
Leave your campsite clean and litter-free!
______/______/______
2.Quiet time is 10:00 PM 6 AM.
DATES OF
3.Pets are to be restrained at all times and owners
RESERVATIONS:
must clean up after pets.
______/______/______ TO
4.You are responsible for keeping your fire under
______/______/______
CAMPSITE NUMBER
control at all times. Please make sure fire is extinguished
_____________
before leaving campsite.
5.

Do not cut down, carve into or damage any live trees. Please leave the natural

the premises that will not abide by the rules and regulations.

SCCR Camping Rules and Regulations

NAME
1.Campers please dispose of all garbage in dumpster.
_____________________
TODAYS DATE
Leave your campsite clean and litter-free!
______/______/______
2.Quiet time is 10:00 PM 6 AM.
DATES OF
3.Pets are to be restrained at all times and owners
RESERVATIONS:
must clean up after pets.
______/______/______
4.You are responsible for keeping your fire under TO
control at all times. Please make sure fire is extinguished ______/______/______
CAMPSITE NUMBER
before leaving campsite.
_____________
5.

Do not cut down, carve into or damage any live trees. Please leave the natural

habitat the way you found it. Only dead and down wood may be used for campfires.

habitat the way you found it. Only dead and down wood may be used for campfires.

6.Please respect other campers campsites and belongings.

6.Please respect other campers campsites and belongings.

Do not trespass on other campsites. If you witness any act of vandalism

Do not trespass on other campsites. If you witness any act of vandalism

to any campsite or vehicles, please report it to the management immediately.

to any campsite or vehicles, please report it to the management immediately.

7.No fighting or boisterous behavior. Keep noise to a minimum to respect

7.No fighting or boisterous behavior. Keep noise to a minimum to respect

other campers. No amplified music allowed.

other campers. No amplified music allowed.

8.Zero tolerance on nudity, public intoxication, and any other unlawful or

8.Zero tolerance on nudity, public intoxication, and any other unlawful or

disrupting behavior.

disrupting behavior.

9.No firearms, fireworks or explosives of any kind are allowed on the premises.

9.No firearms, fireworks or explosives of any kind are allowed on the premises.

10.Use cars, bikes, 4-wheelers or other such vehicles to enter or exit the

10.Use cars, bikes, 4-wheelers or other such vehicles to enter or exit the

campsite area only.

campsite area only.

11.Illegal drugs are prohibited on campsite at all times.

11.Illegal drugs are prohibited on campsite at all times.

12.Campers will not be refunded due to inclement weather.

12.Campers will not be refunded due to inclement weather.

13.Check in time is 2 PM. Check out time is 1 PM.

13.Check in time is 2 PM. Check out time is 1 PM.

14.Children must be supervised at all times. DO NOT leave them unattended.

14.Children must be supervised at all times. DO NOT leave them unattended.

Shoal Creek Canoe Run owners and employees reserve the right to remove anyone from

Shoal Creek Canoe Run owners and employees reserve the right to remove anyone from

the premises that will not abide by the rules and regulations.

the premises that will not abide by the rules and regulations.