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Reservation Form
Customer E-Mail
Important: Enter a valid e-mail address. Receipts will be sent to this address.
E-Mail:*
Category
Product Selection
Qty
Total
Event*
Choose Event
24-June-2014: Summer Wine Dinner at Il Baretto $90.00
Sub-Total:
Allergies/dietary restrictions*
Billing Information
First Name:*
Name on your card
Middle Initial:
Last Name:*
Address Line 1:*
Address Line 2:
Apt. or Suite No.
City:*
State:*
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Phone:*
Payment Information
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Card Number:*
Expiration Month:*
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Expiration Year:*
Year
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Security Code*
Customer Agreement
Billing:
Price does not include tax or gratuity.
Please bring your credit card to the event.
Cancellation:
A fee of $100 will be applied to the card listed above for a cancellation within 48 hours of the event.
By checking this box, I agree to the terms of the Customer Agreement described above.
*
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