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Reservation Form - "Pink is Beautiful" Breast Cancer Awareness Luncheon & Fundraiser Tuesday, October 15, 2024
Island Way Grill - 20 Island Way, Clearwater
11:00 AM to 2:00 PM – Bar is Cash or Credit Card
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Single Reservation
Member ______________________________________________________(circle one below)
Petit Filet Salmon Chicken Piccata Roasted Vegetables Stack __GF ___Check ___Credit Card
Reservation Form - "Pink is Beautiful" Breast Cancer Awareness Luncheon & Fundraiser Tuesday, October 15, 2024
Island Way Grill - 20 Island Way, Clearwater
11:00 AM to 2:00 PM – Bar is Cash or Credit Card
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Single Reservation
Member ______________________________________________________(circle one below)
Petit Filet Salmon Chicken Piccata Roasted Vegetables Stack __GF ___Check ___Credit Card
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Must complete this Lunch Reservation form for all reservations.
To make your reservation and request seats with friends or a full table of 9 or 11, the Host Member MUST complete this form. We will do our best to accommodate your request, but requests will be on a first come, first serve basis so the earlier you get your reservation in, the better we will be able to accommodate you.
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Please list the name of each person that is sitting at your table, their entrée choice and mark if they paid by check or online by credit card. Single reservations can also be made by a member or guest using this form.
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You can include their checks for their lunch or they can mail their luncheon check separately to Reservations Karin Stewart, 225 Windward Island, Clearwater, FL 33767. To pay by credit card use this link:
Host Member ___________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 2 _________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 3 _________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 4 _________________________________________________ ( circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 5 __________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 6 ___________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 7 __________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 8 _________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 9 ___________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 10 _________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
Member/Guest 11 _________________________________________________ (circle one below)
Ranch Steak Seared Salmon Chicken Piccata Vegetable Stack ___ Check ___ Credit Card
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Members--$35.00 Guests--$35.00 Number Attending ____ Total Enclosed $_____
Note:
* If you are sitting at someone’s table and you are NOT the host, please do NOT complete the form. Just let the host member know what you are eating and give her your check or let her know you registered online. You may register online, send or drop off your check to Karin separately, as long as the host includes your name and entree on the form.
* We cannot refund money for cancelled reservations after the deadline because of our commitment to the venue providing our luncheon or program.
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Your Phone Number: ________________ eMail: ___________________________________
​Instructions for Mailing in Reservation Form with your Check
Please make checks payable to: Island Estates Women’s Club Send to:
IEWC—c/o Karin Stewart, 225 Windward Island, Clearwater, FL 33767
Reservation Deadline is Wednesday, October 4th at 12 Noon.
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To PRINT lunch reservation form - Control + P