First Name*		Last Name*
Street Address
City		State	Please select state... Connecticut Massachusetts Rhode Island
Phone Number*	Example: (555) 555-5555	Alt Phone*	Example: (555) 555-5555
Email*
Starting Time*		Ending Time*
Date Requested*	Month... January February March April May June July August September October November December Day... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year... 2010 2011 2012
Type of function:*	Function... Birthday Wedding Fundraiser Dance Private Party Recreation Clam Boil Steak Fry
SPECIAL INSTRUCTIONS:
People Expected*	0 to 25 25 to 50 50 to 75 75 to 100 100 to 125 125 to 150 150 to 175 175 to 200
Options:
Standard Fee $250
Clean Up (+$50)
Add Bartender (+$40)1
Kitchen (+$25)
DJ Services (DJ Will Call)
*Required 1Over 100 People

Important

1. ALL liquid beverages must be purchased from the Lodge. The only exceptions are coffee and enough champagne for one toast.
2. If using the kitchen, you must use your own pots, pans and utensils. Leave kitchen the way you found it.
3. No push pins, tacks, tape, staples or nails of any kind are to be used for hanging decorations. Hooks for hanging will be provided by the Lodge.
4. If bringing your own food, you are responsible for the quality and safe handling of this food.
5. No food will be left behind. Trash dumpsters are available at rear of building. Leave the hall in the same condition or better than you found it.
6. Your 50% Deposit is NON-REFUNDABLE
7. The latest Lodge closing is at 1 AM.