Contact Name: ___________________________________ Phone # (_____)_______________
Trip Date: _____/_____/20___    Class Time:  

# Group Member Name Freefall Photography? Weigh
<160 lbs
Weigh
160 -220
Deposit
Received
Office Use Only
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Total # of jumpers ________ x $60 =$__________ TOTAL DEPOSIT

(circle one) MC or VISA __________________________________ Expires: _________
Cardholder Signature _____________________________________________________

Print out and fill in this skydiving reservation sheet with your credit card information
or Make check or money order payable to:

Above the Poconos Skydivers
69 Center Hill Road
Sugarloaf, PA 18249
(Remember checks are only accepted if received a minimum of two weeks prior to the skydive.
)

Available class times are based upon day of the week, time of year and other bookings
- Call to see what dates and times are available.