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Adult men (age 21+) in any stage of treatment, recovery or in full remission from all forms of cancer are eligible to attend one Reel Recovery Retreat. The Retreats are completely free to the participants; Reel Recovery provides all meals, lodging and fishing equipment. Participants are responsible for their own transportation to and from the Retreat location.

We will NOT be requiring vaccinations/boosters for participants or volunteers at our 2024 Retreats. We strongly encourage each attendee to discuss with your physician your personal risk factors of attending a group gathering.

A signed MEDICAL RELEASE from a physician is required prior to the Retreat.

Also available as a printed form.

    *required

    Desired Retreat - 2024*

    Your Name*

    Address*

    City,*

    State*

    Zip*

    Cell Phone

    Home Phone*

    Your Email

    Name of Emergency Contact During Retreat*

    Emergency Contact's Phone*

    Your Age*

    Shoe Size (for boots)*

    Wader Size (Sm, Med, Lg, XL, XXL)*

    Occupation

    How did you hear about Reel Recovery? (referring clinic/hospital, person, etc.)*

    Where do/did you receive your cancer treatments?*

    Type of cancer; Date of diagnosis; Current status.*

    Do you have any physical restrictions and/or special needs?*

    Do you have any dietary preferences or requirements?*

    Please describe any additional medical conditions (heart disease/stroke, high blood pressure, diabetes, seizures, orthopedic, etc.)

    Please describe all allergies (to medications, bees/insects, food, etc.)

    Have you ever attended a support group or retreat before?*

    yesno

    If so, please describe:

    Please feel free to provide any additional information: