Name*

First Name Last Name

Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number*

Area Code Phone Number

Email*

example@example.com

Date of Birth

Please follow us on instagram and facebook at @notjustagetaway. Click here to also join our private facebook group.

Instagram Handle*

Facebook Handle*

WhatsApp?

RefresHER package*

Smoker?

T Shirt Size *

Private Room Upgrade?

*Additional cost will apply

Do you have a Preferred Roommate?*

Roommate(s) Name

Group Name

Enter a point person if you are with a group

Spa Treatments (Hover for more info)*

None Manicure Pedicure Basic Massage (FULL, Select if you want to be added to Wait List)

Detox Options

Official GLAMPING Gear

Official Glam Robe and Slippers ($45) Personalized Crystal Embellished Wine Glass ($35) Personalized Crystal Embellished Tumbler ($35) Personalized Crystal Embellished Coffee Mug ($35) Glam T-Shirt ($20; add $5 for plus sizes) Glam Pajama Sleep Shirt ($30) Robe Only ($40) Slippers Only ($10) ***Save $5 when purchased with robe***

GlamDinner option (Ultimate Glampers & Saturday Overnight Glampers Only)

Allergies or Special Food Concerns

Location for Shuttle Pickup*

For Ultimate Glampers Only

Special Requests

*