MGM National Harbor Getaway 2020
Sponsored by Florence County Parks and Recreations and C&S Tours, LLC
Trip Dates: May 13-14, 2020
Contact Brenda Brown 843-656-2450
First Name *
Print first name EXACTLY as it appears on the government issued identification.
Your answer
Last Name *
Print last name EXACTLY as it appears on the government issued identification.
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Home Address *
Your answer
City, State, Zip Code *
Your answer
Phone Number (Mobile) *
Your answer
Phone Number #2 (Optional)
Your answer
Email Address *
Your answer
Room Type *
Required
Bed Configuration
Will you travel with the group via motorcoach from Florence? *
Please list roommate(s) below. *
List first and last name of each roommate. If you will not have a roommate, then write NONE in the space below.
Your answer
Emergency Contact's Name *
Please include first and last name of your emergency contact below.
Your answer
Relationship to Passenger *
Emergency Contact's Phone Number *
Your answer
Additional Comments
Please note any additional requests.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy