Fillable Fseprd575490 (USDA Forest Service)

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Fseprd575490 (USDA Forest Service)

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TEMPORARY RIVER
OUTFITTER & GUIDE
APPLICATION
*One application per organization will be considered each season for up to three visits.
*Permits will not be accepted before April 1st.
Permit Holder Information:
Name of Organization
Name of Contact
Person
Mailing Address
Physical Address:
City State
Zip Code
Phone Number
Fax Number
E-mail
TRIP LEADER INFORMATION: (If different than above)
Name: Driver Licence
Number:
Cell Number: State
Home Number:
*Trip leader must be present on trip.
GENERAL DESCRIPTION AND PURPOSE OF TRIP
Purpose and
Description of Trip.
Camping Areas:
Will you be
participating in other
activities within the
Forest? If so, provide
details.
*If more space is needed for the trip itinerary please attach in separate document along with the form on e-mail.
TRIP ITINERARY
Monday - Thursday: 3 launches/day may be allowed. Visitors are encouraged to boat Monday
through Thursday as this period is a low use time, being less crowded and you are more likely to
receive a permit. Friday - Sunday: 2 launches/day may be allowed.
Proposed Date of trip:
Requested
launch time
Proposed launch site: Proposed take out
sites:
Proposed Date of trip:
Requested launch
time
Proposed launch site: Proposed take
out sites:
Proposed Date of trip:
Requested launch
time
Proposed launch site: Proposed take out
sites:
Proposed Date of trip:
Requested launch
time
Proposed launch site: Proposed take out
sites:
Proposed Date of trip:
Requested launch
time
Proposed launch site: Proposed take
out sites:
Provide number of
previously issued
temporary permits
for the Snake Canyon
PARTICIPANTS
Number of
participants expected:
(30 people maximum
per launch, including
guide(s))
Number of guide(s):
Each group requesting a Temporary Outfitter and Guide Permit is limited to 200 service days per
season. A service day is defined as one person (i.e. leader, student, client, participant, etc.) on the
National Forest for any part of one day.
Fees are calculated according to the following table:
Number of Service Days: Flat Fee:
1 to 50 $150
51 to 100 $300
101 to 150 $450
151 to 200 $600
Amount of fees paid
by each participants:
Trip funding sources
provided by
organization?
What do the fees (or tuition) pay for? Check all that apply.
Transportation Insurance
Salary of leader/staff/
guide
Financing other
trips
Meals/Food Camping Fees
Supplies Operating costs
(rent, phone,
utilities, etc.)
Other
If this trip is being offered
through an educational
institution, will credit be
given for participation in
the experience?
Yes
No
GUIDE QUALIFICATIONS: Please send copies of certifications with this application
Guiding:
Providing services or assistance (such as supervision, protection, education, training, packing, touring, subsistence,
transporting people, or interpretation) for pecuniary remuneration or other gain to individuals or groups on national
forest system lands. The term "guide" includes the holder's employees and agents.
Guide Name:
CPR Certification
Expiration Date:
First Aid Certification
expiration Date
Guide Name:
CPR Certification
Expiration Date:
First Aid Certification
expiration Date
Guide Name:
CPR Certification
Expiration Date:
First Aid Certification
expiration Date
Guide Name:
CPR Certification
Expiration Date:
First Aid Certification
expiration Date
EQUIPMENT (Boats, Trailers, Vehicles)
Make Model
Color Year
Other
Make Model
Other
Color Year
Other
Make Model
Color Year
Other
**If more river equipment is used please see the extra equipment sheet**
A state AIS boat decal is required by the state of Wyoming to launch.
To prevent the spread of Aquatic Invasive Species (AIS), you must clean, inspect, and dry your boats and equipment
prior to visiting the Snake River. For information visit: http://gf.state.wy.us/fish/AIS/
.
SAFETY
Provide emergency plan and safety precautions:
(i.e. First aid stations,
radios, cell phones,
EMT’s on site, emergency
contacts, flipped or
wrapped raft, missing
person etc.)
*If more space is needed for the safety plan please attach in separate document along with the form on e-mail.
Accident Reporting: There is limited cell service in the Snake River Canyon, when available dial
911 for emergencies.
Lincoln County Sheriff, Afton, Wyoming (307) 886-5231
Teton County Sheriff, Teton County Sheriff (307) 733-2331
Forest Service River Ranger Crew has radio access and can usually be found at West Table and Sheep Gulch boat
ramps during high use days.
First Aid: One first aid kit adequate to treat on-river emergencies is required. This kit should include equipment to
deal with all types of trauma, broken bones, stings, bites, and resuscitation. Training in use of Automatic External
Defibrillators (AEDs) is highly recommended. AED Locations: West Table Boat Ramp, Gauging Station,
Red Creek and Sheep Gulch Boat Ramp.
Provisions for Protecting the Resource: (sanitation, no-trace techniques, etc.)
Sanitation:
a. Existing toilet facilities will be used to dispose of human waste whenever possible. Otherwise proper minimum
impact techniques will be used. Leave No Trace website: https://lnt.org/
b. All garbage and refuse of any kind must be hauled and properly disposed of off National Forest Lands by the
permittee. The areas authorized for use must be left in the same condition as it was prior to the authorized activities.
The permittee shall be liable for any damages to property of the United States resulting from the activities authorized
in this permit.
------------------------------------------------------------------------------------------------------------------------------------
Wildlife: Wildlife are under stress when encountering humans. Any activity which adds to that stress will not be
tolerated. If activities of the group cause noticeable disturbances to the animals, please leave the area.
ADDITIONAL DETAILS:
Submitting Application:
For faster processing you can e-mail the application to rwebb@fs.fed.us
If you are unable to e-mail your form please mail to:
Jackson Ranger District
Attention: River Permits Office
P.O. Box 1689
Jackson, WY 83001
For more information about this application or general
river information please call: (307) 739-5444
Extra Equipment Sheet
Make Model
Color Year
Other
Make Model
Color Year
Other
Make Model
Color Year
Other
Make Model
Color Year
Other
Make Model
Color Year
Other
Make Model
Color Year
Other
Make Model
Color Year
Other
Make Model
Color Year
Other
Make Model
Color Year
Other
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Completed 19 July 2020

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