Campbell's Lodge Reservation Form

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Please print this form and mail to:
Campbell's Lodge Reservations
49092 Empty Bar Loop

Deer River, MN  56636


Name:______________________________

Address:____________________________

City:_______________________________

State:________________ZIP:___________

Phone:______________________________

Email:_______________________________

Total # of Adults:______________________

Total # of Children:_____________________

Names of Adults in Cabin:_______________

___________________________________

___________________________________

___________________________________

Children & Ages:______________________

___________________________________

___________________________________


Cabin(s) #:___________________________

Arrival Date:__________________________

Departure Date:_______________________

Boat Only (Qty. Needed):______________

Standard Boat/Motor Package: __________

Deluxe Boat/Motor Pkg: _______________

Pontoon (circle one):     21'        24'
(All Boats and Pontoons Require a Deposit - Call for Availability)

Rental Dock Space w/Electric: ___________

Crib____ Highchair_____

TOTAL DEPOSIT
Combined Cabin + Boat Deposit:
$______________

VISA, MasterCard, Cashiers Check, Personal Checks, & Money Orders Accepted. Please do not send cash.

Credit Card #:________________________

Card Type & Exp Date:_________________

Name As Printed On
Card:_______________________________

I agree to the reservation policy as stated.

Signature:_________________________________________Date:____________________