Healing Waters Lodge Pre-Trip Questionnaire Name(s) Email Cell Phone (for airport shuttle pickup) Mailing Address Address Address Line 2 City State Zip Arrival Date of Arrival Airport Shuttle Needed? YesNo Flight Information Airport Flight Number Arrival Time Departure Date of Departure Airport Shuttle Needed? YesNo Flight Information Airport Flight Number Departure Time If driving, please indicate when you expect to arrive Please contact Laura at 406-459-5582 if there are any changes to your travel plans (such as canceled/missed flights, emergencies, illness, etc) so that we can plan accordingly. YesI am interested in reserving private water day(s). Please enter your Name as it appears on your MT Fishing License and your Birthdate-ALS# or Birthdate if that is all you have. Use separate lines for each license. (Required for each guest who will be fishing): Need the following loaner equipment (rods, reels, waders, boots, etc): Food Allergies/Restrictions or Preferences: Physical Limitation or Assistance Requirements: Emergency Contact Information: We strongly recommend you purchase travel insurance by clicking here
