Riverhead Moose Lodge #1742
51 Madison Street • Riverhead, NY 11901
Event Request Form
Please enter a valid phone number.
Do you have an active Moose Membership?
No, but I would like more information.
Member ID# (If available)
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)
Preferred Event Starting Time
Preferred Event Ending Time
Write in hours and date options in additional to the above.
Ballroom (max capacity 220)
River's Edge Outdoor Pavilion (max capacity 80)
Soda, Juice, Water
Level 1 - Beer, Wine, Soda, Juice, Water
Level II - Level I plus Mixed Drinks
Level III - Level II + Premium Top shelf.
Coffee & Tea Bar
Cash Bar for Alcohol
Cash Bar for Alcohol and Soda/Juice
Not Sure Yet
Food & Catering
I am bringing my own food
I would like your catering options
Not Sure Yet
Food & Beverage Requests
Outside Vendors & Extras (please add details in the additional notes)
I am bringing my own DJ
I would like a referral for a DJ
I am hiring a band
I would like a referral for music
I am bringing a Photo Booth
I would like a price on a Photo Booth
I would like a price on Balloons & Balloon Arches
Not sure yet
Our rental comes with White tablecloths in the ballroom only.
I'll use your white tablecloths
I'd like to know table linen color options
I would like a price on white chair covers
I'll bring my own
Miscellaneous Services Wanted
Additional Notes & Needs
Please verify that you are human
Should be Empty: