Last Name                                     First Name
            

  Email
 

  Member #              Number of People             Phone
                                                       

  Date of Reservation             Time                Day
     (MM/DD/YYYY)
                                        

  Special Requirements (e.g. dietary restrictions, large groups)
 

  Booster Chair  Yes    No

  Add to another Table         Name of person with table
                                        

  Type Entreé Selections(s) Here (if required by event)