Form Club Event Confirmation

Host Name *

Member Sponsor Name (if applicable)

Date of Function *

Billing Address *

Billing Phone Number *

Billing Email Address *

Function Start Time *

Function End Time *

Facilities Fee *

Function Head Count *

Will this function have any of the following?

Entertainment

Dance Floor

Tenting

Wedding Clients Only – Please choose your package then proceed to Signature.

Is the Club providing Food and Beverage Services for this event?

Yes

No – Please proceed to signature

Beverage Package - Please Choose One

Consumption Bar

Open Bar

Beverage Add Ons

Specialty Cocktail

Mocktails

Tableside Wine

Food Package - Please Choose One

Buffet

Themed Buffet

Plated

Hors D’oeuvres Add Ons

Passed

Displayed

Action Station

Late Night Bites

My typed name below confirms I understand:

the conditions and policies provided in the Gibson Island Events Brochure.
I must submit my deposit within 14 days to guarantee my facilities reservation.
my deposit will be applied to my function account of credit.
if my function is cancelled, my deposit will be forfeited to the Club.

(Checks can be mailed to: Director of Events, P.O. Box 600, Gibson Island, MD 21056)

Signature *

Form Designer