HighRoller Adventures Reservation Request Call Terry Jertberg at (352) 215 2925 or call (877) 205- 1764 Monday-Friday 9:00-6:00 CST to leave a message
Name: Email Address: Phone#: Alt Phone# Fax#: Departure City: Location of Interest: Select Playa Nicuesa/Costa Rica Puerto Jimenez/Costa Rica Corcovado National Park/Costa Rica Crocodile Bay/Costa Rica Silver King Lodge/Costa Rica Sunset Beach Lodge/Australia Anglers Inn/Mexico Amazon Nemo, Brazil River Plate Outfitters, Brazil Explorer & Cutter, Brazil Arrival Date: Month January February March April May June July August September October November December Year 2006 2007 2008 2009 2010 Nights/Days: Select 5 Nights/6 Days 6 Nights/7 Days 7 Nights/8 Days 8 Nights/8 Days # of Adults: # of Children: Total# in Group: Additional Info: What other activities are you interested in? note: some activities may not be available at all locations Rainforest Trek Mountain Biking Waterfall Rappelling Gold Panning Bird Watching Botanical Gardens Beach Exploration Surfing SPA Services Kayaking Snorkeling How did you find out about HighRoller Adventures? Select Internet Print Advertisment TV Advertisment Word of Mouth Outdoor or Boat Show Other Would you like to receive our newsletter? yes no
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