Please let this request form you are submitting serve as written authorization and approval for DOMINICK’S to charge the described credit card for any and all charges and costs associated with the above detailed event. This request form shall constitute my express written permission for DOMINICK’S to charge my credit card for the penalty fee of $575.00 for cancellation less than two (2) weeks prior to the date of the scheduled event.

To ensure that all stipulations of the contract are upheld, a credit card number must be obtained. Menu selections and the final number of guests should be received no later than seven (7) days prior to your party. You will be charged 100% of the cost for any absent guests in your party. 20% percent gratuity is added to all parties. A 6% sales tax on food and an additional 3% sales tax on alcohol will be included on the total. 35 person minimum required for private events ($2,000 or more contract on Friday/Saturday).