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Kacikewin RV Campground and Cabins
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Please Print out a copy for your records.
Date
Name
*
Address
Phone
Cell
Email
*
How many adults?
0
1
2
3
4
5
6
7
8
9
10
How many kids over 21?
0
1
2
3
4
5
6
7
8
9
10
How many kids under 21?
0
1
2
3
4
5
6
7
8
9
10
Dogs
0
1
2
3
4
5
Cats
0
1
2
3
4
5
If dogs, what breed?
If other pets, specify
Trailer Type
Trailer Size (incl. Hitch& Bumper)
Trailer Width (incl. slides)
How many slides?
Slides side
Electric Heat or Propane
Air conditioner
Washer/ Dryer Unit
Electric Fireplace
Amperage Required
30 amp
20 amp
15 amp
Doesn’t Matter
How many boats?
0
1
2
3
4
5
How many ATV’S?
0
1
2
3
4
5
Trailer Liability insurance
Yes
No
Boat Liability insurance
Yes
No
Have you been here before?
Yes
No
Are you planning to purchase a new trailer?
1 year
2 year
3 and over
Other comments
Verification
Please enter any two digits with no spaces (Example: 12)
*
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