Black Ice 4 BOOKING FORM Name * First Name Last Name Email * Location * Age * Gender * Male Female Nationality Instagram Handle * Occupation * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country T-Shirt Size * Small Medium Large XL 2X 3X How Will You Be Attending? * Solo Coming With a Friend Not Sure Yet Please Select Your Occupancy * Single Occupancy: $2,950.00 per person Double Occupancy: $2,500.00 per person If you are attending with one or more people. Please list their names. Please List Any Dietary Restrictions. Any sleeping arrangements preferences? i.e request room with a friend, request same gender roommate (for double occupancy rooms only) What are you looking forward to most about Black Ice 4? I have read, understood and agreed to the trip details and the terms and conditions outlined on the “Terms and Conditions” page. * Yes I am ready to make a payment. * Yes No Enter the name of your referral First Name Last Name Thank you for completing your registration form for Peculiar Travel’s Black Ice 4! A payment link and client portal will be sent to you by email within 2 business days.PECULIAR TRAVEL, LLC
