Contact Form

BLACK RIVER
CONTACT US

INQUIRY FORM

BOOKING FORM

COMPLETE THIS FORM IF YOU WANT TO MAKE A RESERVATION

THANK YOU, WE WILL PROCESS THIS INFORMATION

Something went wrong. Please check the fields and send the form again.

Something went wrong, your email address is invalid.

Something went wrong, your telephone number is invalid.

Lodge:

From:

To:

PAYMENT DETAILS

COMPLETE THIS FORM IF YOU WANT TO MAKE A RESERVATION

1. Bank Deposit: Bank of America

  • Make deposit to: Juan Pablo Portela
  • Receiving Bank Name: BANK OF AMERICA
  • Receiving Bank full address: 113 Brazos Landing Court - Freeport, Tx 77541
  • Receiving Bank swift code or ABA routing number: 063100277 (wire from USA)
  • Beneficiary (recipient) full name: JUAN PABLO PORTELA
  • Beneficiary (recipient) full address: Leyenda Patria 2980 Ap.4 Montevideo - Uruguay
  • Beneficiary (recipient) account number at receiving bank: 8980 8476 2699
  • Reason for transfer: Payment for vacation trip

*If you have any questions concerning this invoice, contact Juan Pablo Portela.

Uruguay Phone: +598 98722969 - USA Phone: 1 866 477 0917 - pablo@blackriveroutfitters.com

2. Send a check to the following address in USA: 113 Brazos landing court Freeport Tx. 77541. (all checks have to be at the order of: Juan Pablo Portela)