Origins:Amazonia Dinner Series Reservation Form
Make your reservation for O:A, deposit required
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Dinner Deposit
$
15.00
- Price: $65, tax and gratuity not included- Dinner with complimentary welcome cocktail (Non-Alcoholic cocktail available). - $15 Deposit is non-refundable.- Changes may be made to reservation depending on availability.
Quantity
1
2
3
4
5
6
7
8
9
10
Dinner & Drinks Deposit
$
20.00
- Price: $85, tax and gratuity not included- Dinners with Cocktail, Wine & Beer Pairings- Deposits are non-refundable. - Changes may be made to reservation depending on availability.
Quantity
1
2
3
4
5
6
7
8
9
10
Total
$
0.00
Preferred Date 1:
*
-
Day
-
Month
Year
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Preferred Date 2:
-
Day
-
Month
Year
Dates Available: 12/14, 12/13, 12/21, 12/22, 12/28, 12/29
Preferred Date 3:
-
Day
-
Month
Year
Dates Available: 12/14, 12/13, 12/21, 12/22, 12/28, 12/29
Special Dietary Request?
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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