NICE MOVES IN BLOOM Full name (as on passport) * Preferred name, if different PRONOUNS Date of birth * MM DD YYYY Email * ADDRESS * Address 1 Address 2 City State/Province Zip/Postal Code Country PHONE NUMBER * Room request * QUEEN (UPPER LEVEL) KING (LOWER LEVEL) KING (UPPER LEVEL) TWIN (LOWER LEVEL) TWIN (UPPER LEVEL) QUAD OCCUPANCY? * SINGLE (1 person) DOUBLE (2 people) QUAD (4 people) *if Double/Quad Occupancy - who are you sharing a room with? PLS ALSO HAVE THEM COMPLETE A BOOKING REQUEST Tell us a little bit about you; why you are joining this Retreat and what would you like to get out of it? * I acknowledge that I have read and agree to the terms outlined via the link below * RETREAT TERMS + CONDITIONS YES Thank you!