Facebook Flocknote Email Phone

Step 4 Rooming List

- Plan Your Stay

Thank you for submitting your rooming list. We will assign the room numbers based on the availability of the rooms. You are welcome to email your list to [email protected] or submit this form. Either way, we will need an emergency contact for each person coming to our facility. Please let us know if any need King rooms upstairs.
This form is not accepting responses at this time.
- Retreat Group Name Please enter valid data.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
- Room
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Emergency Contact Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
Submit

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Bishop DeFalco

Retreat & Conference Center
806-383-1811

Step 4 Rooming List