Event Request Form

Riverhead Moose Lodge #1742
51 Madison Street • Riverhead, NY 11901
Event Request Form
Name*

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Do you have an active Moose Membership?*

YesNoNo, but I would like more information.WOTM EventLOOM Event
Member ID# (If available)
Event Name
Event Type*

WeddingSweet 16QuinceañeraLunchDinnerBirthday PartyAnniversaryMemorial ServiceBreakfastGraduationBusiness EventNon-Profit Event/FundraiserConferenceOther
Please Describe Event and Any Special Needs such as Bridal Parties, Courts of Honor and special table or dance floor set ups.
Number of Guests*
Please note our maximum # of guests in our ballroom is 220. The River's Edge Outdoor Pavilion is 80.
Guaranteed Number of Guests
Preferred Event Date (Please note our ballroom is not available for rentals on Friday nights)*

MonthDayYear
Date
Preferred Event Starting Time*

Hour Minutes

AM/PM Option
Preferred Event Ending Time*

Hour Minutes

AM/PM Option
Write in hours and date options in additional to the above.
VENUE SPACE*

Ballroom (max capacity 220)River's Edge Outdoor Pavilion (max capacity 80)Outdoor spaceOther
Beverage Service*

Soda, Juice, WaterLevel 1 - Beer, Wine, Soda, Juice, WaterLevel II - Level I plus Mixed DrinksLevel III - Level II + Premium Top shelf.Coffee & Tea BarCash Bar for AlcoholCash Bar for Alcohol and Soda/Juice"Mocktail" MenuNoneNot Sure Yet
Food & Catering*

I am bringing my own foodI would like your catering optionsNot Sure Yet
Food & Beverage Requests
Outside Vendors & Extras (please add details in the additional notes)

I am bringing my own DJI would like a referral for a DJI am hiring a bandI would like a referral for musicI am bringing a Photo BoothI would like a price on a Photo BoothI would like a price on Balloons & Balloon ArchesNot sure yet
Our rental comes with White tablecloths in the ballroom only.

I'll use your white tableclothsI'd like to know table linen color optionsI would like a price on white chair coversI'll bring my own
Miscellaneous Services Wanted
Additional Notes & Needs
Please verify that you are human*
Should be Empty: