Website Access Request
Request access to our website for menus, catering, events, and family-related content. Please complete all required sections so we can review your request.
Contact Information
Tell us how we can reach you about your website access request.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
City & State
Access Purpose – Why are you requesting access to the website?
View menus and services
Book catering/private dining
Are you interested in any of the following?
Catering
Private dining
Cooking classes
Seasonal menus & specials
Senior community events
Privacy & Security
Important: This website is private. Please review and respond to the privacy and communication statements below.
I understand this website is private, and access is limited to approved members. I agree not to share my login or any private content outside of the approved family/guest group. ☐ I agree
*
I agree
I understand that if my name appears on the site (for events, photos, or family lists), only my first name and (optional) month/day of birth will be shown.
*
I agree
I do not want my name displayed at all
Can we email you about upcoming events, menus, and specials?
*
Yes, I’d like to receive updates
No, I prefer not to receive updates
Account & Access Details
Share your preferred login details so we can set up or update your access.
Preferred Username
*
Preferred Email for Login (if different from above)
Have you had access to this site before?
*
Yes
No
Special Notes / Accessibility
Share any information that will help us better serve you and your guests.
Do you have any food allergies or dietary restrictions you’d like us to know?
Any special requests or comments?
Electronic Signature
By typing your name below, you confirm that the information provided is accurate to the best of your knowledge.
Electronic Signature (Type Full Name)
*
Date
*
-
Month
-
Day
Year
Date
Submit Request
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