Personal Information:

First Name

Last Name

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Email Address

Reservation Information

Note: Prices for the Brunch: $16.95 per Adult and $10.00 per child.

Your Requested Brunch Times

	11:00 AM thru 3:30 PM
	11:30 AM	12:00 PM	12:30 PM	1:00 PM	1:30 PM	2:00 PM	2:30 PM	3:00 PM
You must select only one time slot for your seating arrangements.

Total number in persons in your party

Number of Adults

Number of Children

TOTAL AMOUNT ($16.95 per Adult; $10.00 per Child)

PayPal Payments Notice:

If you have a PayPal account, please make sure you use the correct "email address" and password that is associated with the account. PayPal will not process your payment if you enter an "email address" that is associated with your PayPal account and you do not remember the password associated with that "email address". Thank you from The Vue's Staff.

Optional Information

Optional Instructions/Questions

Credit Cards Accepted

Indicates Response Required