Off Trip Lodge Reservation Form by Miramar | Feb 25, 2018 | Off-Trip Lodge Stay Request and Report FormUse this form to make an initial request, make a change to or cancel a request or to report the rooms used or issues. You may include multiple members and guests on one form if you will send all payments in together. Members in your group who will be paying separately should submit a separate form.If you have questions or difficulty with this form, contact the Off-Trip Lodge Stay Coordinator: Bill Bernstein [email protected]* RequiredLast Name *Your answerFirst Name *Your answerPurpose of Request *Initial request for stayChange dates or number of peopleIdentify rooms used and/or report issuesCompletely cancel requestOther:Email Address *Your answerMobile Number *Your answerOther numberYour answerFirst night of stay (mm/dd/yyyy) *Requested first night if initial, updating or canceling a request. New first night if changing first nightYour answerNextPage 1 of 5Never submit passwords through Google Forms.This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy Forms