Sugar Lake RV Park Application
Call for Daily • Weekly • Monthly Rates* *our prices are subject to change upon season, availability, and local events. Contact: (702)-528-5705
PERSONAL INFORMATION
First Name
Last Name
Date of Birth
Phone Number
Email Address
Permanent Address
RV INFORMATION
RV Year- Make - RV Model
Length of RV
RV Plug 30 or 50 Amp?
RV License Plate Number - State
Vehicle License Plate Number - State
Vehicle 2 License Plate Number -State
STAY DETAILS
For daily reservations 2 day minimum required
Arrival Date
Departure Date
Number of Occupants
Pets
Yes
No
How many? Breed?
What brings you to Shuqualak, MS?
Vacation/Leisure
Work
EMPLOYMENT
Required for extended stays (30 days/+)
Current Employer
Employer Phone Number
EMERGENCY CONTACT
Full Name
Relationship
Phone Number
ADDITIONAL INFORMATION
Comments
How did you hear about us?
Local Sign
Local Establishment
Online
Referral
If referral, who can we thank?
ACKNOWLEDGMENT & SUBMIT
We offer 2 simple ways to make your payments. Please choose one:
online payment (we will provide an easy link for you to submit your payments)
in person bank deposit
I certify that the information provided is true and correct to the best of my knowledge and authorize its verification. I understand that providing false information may result in the denial of my application.
Acknowledge: Sugar Lake RV Park MS LLC management is not responsible for any accidents, fire, theft, or acts of nature.
Today's Date
Your Signature
*
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