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Group table (Party of 6 or more) _______ Individual table ________

Social Table (large table with other couples to enjoy your night with) _________

Special instructions___________________

PAVILION GRILLE NEW YEARS EVE RESERVATION 2019


NAME ________________________________________

PHONE ________________________________________

ADDRESS ________________________________________

EMAIL ADDRESS ________________________________________ TIME ________

IF GROUP, TOTAL # AT TABLE ______


TABLE UNDER WHOSE NAME ________________

_______ @ $150.00 ($120 + $8.40 sales tax + $21.60 service charge)

Total $__________________
DINNER & DANCE 7:30 p.m. $ __________ 1 - $150.00
Includes 7% Sales Tax $ __________ 2 - $300.00
Includes 18% Service Charge $ __________ 3 - $450.00
$ __________ 4 - $600.00
$ __________ 5 - $750.00
$ __________ 6 - $900.00
Fax # 561-998-7564
There is a $35.00 per person cancellation fee.
Reservations are transferable but non-refundable after Tuesday, December 18th, 2018
The Pavilion Grille is authorized to Charge my Credit card

Amount $____________ Visa _____ Master Card _____ AMEX _____

Card Number__________________________________

Exp Date_______ Code________

Signature ________________________________________________________________
PARTIES MUST BE PAID IN FULL TO COMPLETE RESERVATION