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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

​ 

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

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