Name: Lesley Groff

Name: Lesley Groff Address: Phone Number: Cell Number: Email: Date(s) Requested: August 5th Type of Trip: Small Mouth Bass AM 0 PM 0 3O4O 50 67 77 8 0 Hour Trip Meeting Location: Jefferson Beach Marina Departure Time: 3:00pm Booked At: Phone/internet *License Yes/No #: No/will have Captain Kevin Backus Phone/ Fax (586) 771-8817 Cell (586) 206-4172 [email protected] www.mrmuskiecharters.com $100.00 deposit required to hold the date Send deposit to: 23323 Liberty Street St. Clair Shores, MI 48080 Price: S 800.00 Discounts: Licenses: Subtotal: Deposit: Balance: S 800.00 S 100.00 Pd cc S 700.00 • See website for meeting locations & directions. • Fuel surcharge may apply. • 15%-20% gratuity is customary for first mate. • *Canadian fishing licenses are required and they must be printed out and brought to the charter. Mr. Muskie Charters will happily purchase licenses for a fee of $35 per license. All license information must be submitted and prepaid (minimum 14 days) prior to your charter date. Licenses can be obtained at www.mrmuskiecharters.com. Final balance is due the day of your charter. Charters that don't show up will be billed the full balance. Rates are based on 5 people or less. CREDIT CARD # CARD TYPE: NAME: EXP. DATE CCV: EFTA00308383