Family Holiday Weekend – Final Details – UCLA Lake Arrowhead Lodge

Please note, your reservation will NOT be confirmed until we have received this form. Registration form must be completed within 24 hours of room reservation to hold your spot.

Once you have submitted your registration, you will receive an email confirmation within 3-5 business days. The email confirmation will include total payment due.

A deposit will be charged to your card on file (card used to make your room reservation) within one week. Should you have any questions regarding your payment, please call (909) 337-2478 or email bwresort@ha.ucla.edu.

YOUR HOLIDAY STAY INCLUDES:

Cozy accommodations in our charming two-story condolets.
Gourmet meals prepared by our chef, served in our Main Lodge dining room.
Family-focused programming hosted by our student counselors and professional staff.

Family Name Your Reservations are Under*

Eligibility

Select all that apply

I am a UCLA Alumnus/Alumna
I am a current UCLA Full-Time Faculty
I am a current UCLA Full-Time Staff
I am a current UC Alumnus/Alumna, Staff, or Faculty
I have no affiliation with the UC system

Holiday*

Email*

Phone*

Cell Phone Number During Your Stay*

(For our staff to contact you in case of an emergency.)

We would like to have your room perfect when you arrive. Please let us know if someone in your party needs a crib, bed rails, etc.

(All rooms have foam pillows and non-wool blankets.)

Parking (included with your stay)

Please list the cars your party will bring.

Car One*

Make/Model

Color

License Plate #

Car Two

Make/Model

Color

License Plate #

Car Three

Make/Model

Color

License Plate #

Guest Information

GUEST 1 (Qualifying Applicant)*

First Last

Adult / Child 1*

Occupation

Dietary Restrictions (please specify):

Special need that should be considered as I am scheduled for activities:

During my stay, I am having a(n):

Birthday
Anniversary

Date

Age

Number of Years

GUEST 2

First Last

Adult / Child 2

For a child, please select the grade they will start this Fall or their current age (if under 5).

G2 Occupation

Guest 2 Grade/Age*

G2 Dietary Restrictions (please specify):

G2 Special need that should be considered as I am scheduled for activities:

G2 During my stay, I am having a(n):

Birthday
Anniversary

G2 Date

(during your week only, please)

G2 Age

G2 Number of Years

GUEST 3

First Last

Adult / Child 3

For a child, please select the grade they will start this Fall or their current age (if under 5).

G3 Occupation

Guest 3 Grade/Age*

G3 Dietary Restrictions (please specify):

G3 Special need that should be considered as I am scheduled for activities:

G3 During my stay, I am having a(n):

Birthday
Anniversary

G3 Date

(during your week only, please)

G3 Age

G3 Number of Years

GUEST 4

First Last

Adult / Child 4

For a child, please select the grade they will start this Fall or their current age (if under 5).

G4 Occupation

Guest 4 Grade/Age*

G4 Dietary Restrictions (please specify):

G4 Special need that should be considered as I am scheduled for activities:

G4 During my stay, I am having a(n):

Birthday
Anniversary

G4 Date

(during your week only, please)

G4 Age

G4 Number of Years

GUEST 5

First Last

Adult / Child 5

For a child, please select the grade they will start this Fall or their current age (if under 5).

G5 Occupation

Guest 5 Grade/Age*

G5 Dietary Restrictions (please specify):

G5 Special need that should be considered as I am scheduled for activities:

G5 During my stay, I am having a(n):

Birthday
Anniversary

G5 Date

(during your week only, please)

G5 Age

G5 Number of Years

GUEST 6

First Last

Adult / Child 6

For a child, please select the grade they will start this Fall or their current age (if under 5).

G6 Occupation

Guest 6 Grade/Age*

G6 Dietary Restrictions (please specify):

G6 Special need that should be considered as I am scheduled for activities:

G6 During my stay, I am having a(n):

Birthday
Anniversary

G6 Date

(during your week only, please)

G6 Age

G6 Number of Years

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Holiday Weekends

Final Details

Parking (included with your stay)

Guest Information