VALENTINE’S DAY BOOKINGS FORM Contact for all requests for information or reservations for Valentine’s Day: [email protected] or (02) 9252-8017 Online bookings not accepted on Valentine’s Day. Terms & Conditions: • Only the Bowery Lane Valentine’s Day Menu will be available for dinner service on Saturday 14th February 2015. Banquet style set menu with a glass of Mumm Champagne on arrival. $95pp. • Full pre-payment of $95pp is required for bookings, and any bookings will not be confirmed without completing this booking form and leaving credit card details as pre-payment for all tables at Bowery Lane on Valentine’s Day. • All further beverages on consumption is to be paid on the day you dine at Bowery Lane. • We require confirmation of final numbers 48 hours prior to your booking. • Your booking is for up to 2.0 hours, with the possible arrival times being: 6:00pm – 6:30pm & 8:15pm – 8:30pm • Communal table seating will be removed for Valentine’s Day. • Please indicate dietary requirements when placing your booking. Payment Options: • -‐ Credit cards: MasterCard, Visa, AMEX. See next page for credit card authorisation form to pre-pay via credit card. Booking Details: Client Name: _______________________________________ Address: _______________________________________ Email: _______________________________________ Phone: _______________________________________ Time & Date of Booking: _______________________________________ Number of Guests: _______________________________________ Which Set-menu Option: Valentine’s Day Set Menu Cost Per Person: $95pp Credit Card Details: Type of Card: Amex Diners Card Number: _______________________________________ Expiry: ____ /____ CCV: __________ Name on Card: _______________________________________ Email address: (for receipt) _______________________________________ Amount of pre-payment to be charged to card: Visa Mastercard $190.00 I authorise Bowery Lane to deduct the above amount from my Credit Card: By signing this form I acknowledge that I have read all Terms & Conditions and agree to the same and I authorise MX Sydney trading as Bowery Lane to deduct the $95pp booked on this form from the Credit Card listed above: Signature: _______________________________________ Date: _______________________________________
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