Kingsmill Resort Registration

First Name*

Last Name*

Nickname/Middle Name/Surname

Your Street Address*

Suite/Apartment

City*

State/Province/County*

Country*

Home Phone*

Cell Phone

Primary Email Address* (Do NOT use Hotmail email addresses, it will be rejected as SPAM)

Secondary Email Address (Do NOT use Hotmail email addresses, it will be rejected as SPAM)

Mode of Transportation
AirlineCar

Arrival Date: (Month/Day/Year)*

Airline Name*

Flight Number*

Arrival Time*

Departure Date: (Month/Day/Year)*

Airline Name*

Flight Number*

Departure Time*

Gender/Sex*
MaleFemale

Kingsmill Resort and Spa*
Williamsburg

Who would you like to room with? (One person please, there is not a guarantee you will be placed with this person, however we will try our best. )

Please enter the phrase as it is shown in the box above.