Nahanni National Park Reserve of Canada

Reservation Request Form

Registration # _________________________

Reservation # _________________________

Complete this form in order to request a reservation to travel through Nahanni National Park Reserve. Only 24 people (12 private users and 12 commercial users) may arrive at Virginia Falls each day. Groups may camp at Virginia Falls for a maximum of two nights. Each member of the group must pay a Park-User Fee before we will confirm a reservation request. Please provide an alternate reservation request date, in case your preferred date isn't available.

Date of Request: _________________________
Trip Type: Private [ ]     Commercial [ ]    Custodial [ ]
What is a Custodial Group?

Trip Leader's Name: _________________________
(your group will be referred to by this name upon registration)

Address:
___________________________________________________________

City: _________________________

Province/State: _________________________

Postal Code: _________________________

Country: _________________________

Phone: _________________________

FAX: _________________________

E-mail: _________________________

Anticipated Group Size (maximum 12): _________________________

Air Charter Company: _________________________

Start Location: _________________________

End Location: _________________________

Start Date: _________________________

End Date: _________________________

Date of arrival at Virginia Falls (This is your reservation request date):
(preferred date) _________________________

(alternate date) _________________________

Your reservation request will be processed based on available reservation dates at Virginia Falls, and after your Park-User Fee has been approved. A notice of confirmation will be sent to you, at which time we will request additional information including names and addresses of all group members, types of equipment you will use (i.e. canoe, raft, etc.) In addition, a 24-hour emergency contact in case of accident will be required. Remember... this is only a reservation. You must still register, in person or by phone, immediately prior to departing for your trip!

How do you wish to pay for your reservation?
VISA [ ]   MasterCard [ ]  American Express [ ]

Card Number _________________________

Expiry Date _________________________

Name of Card Holder _________________________

Contact Numbers for Card Holder:

Phone _________________________

FAX_________________ ________________

Please note: Paid reservations are 50% refundable until March 31, and 100% non-refundable after March 31.

Return completed form to:

Nahanni National Park Reserve
P.O. Box 348
Fort Simpson, Northwest Territories
Canada
X0E 0N0
Telephone: (867) 695-3151
FAX: (867) 695-2446

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