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ARIZONA GAME AND FISH DEPARTMENT’S
Ben Avery Shooting Facility
4044 West Black Canyon Boulevard * Phoenix, Arizona 85086-7043
Phone: 623 582-8313  Fax: 623 582-5317
 www.basfaz.com  *  www.azgfd.com
 Camping Reservation Request

Name:
Address:
City:

State:     Zip:

Home Phone:

Work Phone:

E-Mail:

Fax #:        

Driver's License #:

 Driver's License State:

RV License Plate #:    Trailer License State:
RV Model & Type:
Trailer Length: 

   # of People in Camp:

Date of Arrival:

  Date of Departure:   

Utilities: Water & Electric ($25.00 per night)    No Utilities ($10.00 per night)
Primitive ($5.00 per night) (special events only)
Preferred Site # (pending availability):
Will you accept a site with no Utilities (If water & electricity is not available)?  Yes     No
Special Accommodations Needed:
Comments:

The Arizona Game and Fish Department (AGFD) prohibits discrimination on the basis of race, color, sex, national origin, age or disability in its programs and activities.  If anyone believes they have been discriminated against in any of the AGFD’s programs or activities, including its employment practices, the individual may file a complaint alleging discrimination directly with the AGFD Deputy Director, 2221, W. Greenway Rd., Phoenix, AZ 85023, (602) 789-3290 or U.S. Fish and Wildlife Service, 4040 N. Fairfax Drive, Suite 130, Arlington, VA 22203.

 Persons with a disability may request a reasonable accommodation, such as a sign language interpreter, or this document in an alternative format, by contacting the AGFD Deputy Director, 2221 W. Greenway Rd., Phoenix, AZ 85023, (602) 789-3290.  Requests should be made as early as possible to allow sufficient time to arrange for accommodation.