2016
Office Use Only
Order # _________________
Date: _______________________
Mailed: ______________________
Retail
1. Purchaser’s Info: (Who is buying the passes?)
Name:_________________________________________________________ Email Address:________________________________________________
Address:_______________________________________________________ City, State, Zip:________________________________________________
Day Phone:_____________________________________________________ Night Phone:__________________________________________________
2. Pass-Holder Info: (Who is getting a pass? - Include additional names on a separate form)
Office Use
Only
2016 Pass#
Name
Birthday
Age
Circle One
(1) ______________________________________________________
___________
______ Gold / Silver
Renew / New
_____________
(2) ______________________________________________________
___________
______ Gold / Silver
Renew / New
_____________
(3) ______________________________________________________
___________
______ Gold / Silver
Renew / New
_____________
(4) ______________________________________________________
___________
______ Gold / Silver
Renew / New
_____________
(5) ______________________________________________________
___________
______ Gold / Silver
Renew / New
_____________
3. Payment Amount
(Gold Pass Price: 12+)
4. Payment Information (One form of payment only)
x
$74.99 plus tax = $80.24x
(Silver Pass Price: 4-11)
x
$59.99 plus tax = $64.19 x
(Quantity) =
( Gold Total)
= (Quantity) =
Check or Money Order
(Silver Total)
Check or Money Order #:____________________________
Credit or Debit Card
Visa
MC
Amex
Disc
Card # __________________________________________
=
x
(Silver Total) + (Handling)= Order Total
____________
+
_________ + $8.00
(Gold Total)
Circle One
= ____________
(Orders that are not completed with total, handling fee and order total or full payment will not be accepted and will be sent back. )
5. Purchaser’s Agreement (Please read and sign below)
Expiration Date: _______________
Card Verification Number: ________
(The last three digits of the number found on the reverse side of your credit or
debit card, or four numbers on the front of your Amex.)
Card Holder’s Name: ______________________________
(Exactly as shown on the card)
Card Holder’s Signature: ____________________________
Disclaimers: Season passes, used or not used, are non–refundable, non-transferable and
do not guarantee admission into the park if closed due to weather, maintenance or park buyout.
Season passes are property of Geyser Falls Water Theme Park at Pearl River Resort. Hours and dates
of operation are subject to change without notice. Season Passes will be valid thru the last day of
operation or Sept. 30th, whichever comes first. Failure to supply correct age of Silver pass holders will
void season pass. Admissions under 12 years of age must be accompanied by a chaperone 16 years of
age or older at all times. Full payment must be received before passes will be activated.
By signing below, I confirm that I have read, understand, and have explained the above disclaimer to all
pass holders that I am purchasing for.
6. Submitting Your Order
By Mail:
Geyser Falls Water Theme Park
Attn: Season Pass Dept
P.O. Box 6046
Choctaw, MS 39350
By Fax:
Attn: Season Pass Dept
Fax: 601.389.5501
Purchaser’s Signature: _______________________________________ Date: _______________
Important Order Information
Order Confirmation - Include your e-mail address and you will receive an e-mail confirmation within 5 business days of receiving your order.
Pass Upgrades - Gold passes will be available at Geyser Falls’ front gate for Silver pass holders who turn 12 during the 2016 season. Upgrading will require a $15.00
charge + tax and parent’s permission.
IF YOU HAVE ANY QUESTIONS PLEASE CALL THE SEASON PASS DEPARTMENT AT 601-389-3100 Ext. 31812
Season Passes postmarked after January 31, 2016, WILL NOT receive this same discount.
Prices Increase February 1st
GROUP ORDER FORM
Group tickets include all day park admission on your chosen event date.
(Please note that children 3 and under are free and may not be counted in your group of 20 or more.)
Group tickets may be purchased at the Clearwater Key front gate upon arrival with cash, credit, or debit card.
NO PERSONAL CHECKS. All tickets cannot be split up and must be purchased as one transaction.
Not valid on Saturdays.
Group Name:________________________________________
Contact Name:______________________________________
Address:_______________________________________________________________________________________________
City:_____________________________________________ State:_____________________ Zip:_______________________
Main Phone:_________________________________________ Other Phone:_________________________________________
Event Date: _________________________________________ Group Type:________________________________________
$26.99
per person
(plus tax =
$28.88)
Quantity
Pre-Purchased Tickets
Must be purchased ten (10) days prior to your visit to the park.
Offer cannot be combined with any other offer.
Total
Group Tickets _________x $28.88 (tax inclusive) $_________
$_________
Subtotal
$________
Total
Minimum
of
20
Guests
Payment Method: (Check One) NO PERSONAL CHECKS!
Cashier’s Check
Money Order
Master Card
Visa
Discover
American Express
Credit Card
Credit Card Number: ________________________________
Exp.Date: ________
Signature: _________________________________________
Date: ___________
(Name as shown on card)
$28.99
per person
(plus tax =
$31.02)
At The Gate Tickets
Offer cannot be combined with any other offer.
Purchaser’s Agreement: Please read and sign below
Disclaimer: Pre-purchased tickets are the property of Geyser Falls Water Theme Park at Pearl River Resort. Hours and dates of operation are subject to change without
notice. Tickets are valid any operating day unless noted other wise on the ticket. As the ticket purchaser I understand it is my responsibility to ensure my group is
aware of all park rules and regulations. Rules are posted at the park entrance and on safety signs throughout the park. A copy of the park Code of Conduct is available
by request from our office or online at www.GeyserFalls.com. For guest safety, Geyser Falls strongly recommends and I understand that if I have any attendees
between the ages of 12 -18 years of age, a responsible chaperone should be provided at a ratio of at least 1 chaperone per 15 youth. Additionally, Geyser Falls strongly
recommends and I understand that for participants under the age of 12, constant adult supervision is required by a responsible adult at a ratio of at least 1 chaperone
per 5 children. My failure to abide by these terms may result in the exclusion of both myself and my children/youth participant from Geyser Falls without a refund of
purchase price. I understand that, ultimately, my child’s / youth participant’s safety and supervision is my responsibility.
Purchaser’s Signature: ______________________________________________________________ Date: ________________________________
Mail to: Attn: Group Sales Geyser Falls Water Theme Park, P.O. Box 6046, Choctaw, MS 39350
Fax to: Geyser Falls Water Theme Park, (601) 389-5501
Revised
7/2015
GROUP ORDER FORM
Group tickets include all day park admission on your chosen event date.
(Please note that children 3 and under are free and may not be counted in your group of 20 or more.)
Group tickets may be purchased at the Clearwater Key front gate upon arrival with cash, credit, or debit card.
NO PERSONAL CHECKS. All tickets cannot be split up and must be purchased as one transaction.
Not valid on Saturdays.
Group Name:________________________________________
Contact Name:______________________________________
Address:_______________________________________________________________________________________________
City:_____________________________________________ State:_____________________ Zip:_______________________
Main Phone:_________________________________________ Other Phone:_________________________________________
Event Date: _________________________________________ Group Type:________________________________________
$25.99
per person
(plus tax =
$27.81)
Quantity
Pre-Purchased Tickets
Must be purchased ten (10) days prior to your visit to the park.
Offer cannot be combined with any other offer.
Total
Group Tickets _________x $28.88 (tax inclusive) $_________
$_________
Subtotal
$________
Total
Minimum
of
50
Guests
Payment Method: (Check One) NO PERSONAL CHECKS!
Cashier’s Check
Money Order
Master Card
Visa
Discover
American Express
Credit Card
Credit Card Number: ________________________________
Exp.Date: ________
Signature: _________________________________________
Date: ___________
(Name as shown on card)
$28.99
per person
(plus tax =
$31.02)
At The Gate Tickets
Offer cannot be combined with any other offer.
Purchaser’s Agreement: Please read and sign below
Disclaimer: Pre-purchased tickets are the property of Geyser Falls Water Theme Park at Pearl River Resort. Hours and dates of operation are subject to change without
notice. Tickets are valid any operating day unless noted other wise on the ticket. As the ticket purchaser I understand it is my responsibility to ensure my group is
aware of all park rules and regulations. Rules are posted at the park entrance and on safety signs throughout the park. A copy of the park Code of Conduct is available
by request from our office or online at www.GeyserFalls.com. For guest safety, Geyser Falls strongly recommends and I understand that if I have any attendees
between the ages of 12 -18 years of age, a responsible chaperone should be provided at a ratio of at least 1 chaperone per 15 youth. Additionally, Geyser Falls strongly
recommends and I understand that for participants under the age of 12, constant adult supervision is required by a responsible adult at a ratio of at least 1 chaperone
per 5 children. My failure to abide by these terms may result in the exclusion of both myself and my children/youth participant from Geyser Falls without a refund of
purchase price. I understand that, ultimately, my child’s / youth participant’s safety and supervision is my responsibility.
Purchaser’s Signature: ______________________________________________________________ Date: ________________________________
Mail to: Attn: Group Sales Geyser Falls Water Theme Park, P.O. Box 6046, Choctaw, MS 39350
Fax to: Geyser Falls Water Theme Park, (601) 389-5501
Revised
7/2015