Request To Add Rewards Points
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Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Location Visited:
*
Please Select
Haines City
Winter Haven
Lake Wales
Server Name
*
Restaurant Check Number:
*
Typically 2-6 digits
Date Dined:
*
-
Month
-
Day
Year
Subtotal of Check:
*
Points are not available for tax, tips, or gift card purchases.
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Sample Receipt
Upload Itemized Receipt
*
Browse Files
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Full Itemized Receipt is required for points to be added to your account.
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