First Name *

Last Name *

Phone *

Email *

Date of Birth *

Instagram Handle *

Where do you live? (City, State) *

Zip code *

Is this a Birthday Celebration? *

Yes

Birthday Person's Name (if not you)

First & Last Name

Choose Package Day *

Date of the Party *

Time Slot *

Guest List *

Maximum of 12 Guests (Seating accommodates 6 people maximum)

One Bottle of Rosé *

One Bottle of Rosé

One Bottle of Remy Martin XO Night Edition

One Spirit of Choice *

One Premium Hookah *

VYBZ TOTAL PRICE

By checking the boxes below I acknowledge that I understand the following: *

I acknowledge that my time slot and bottle selection cannot be changed after purchase.

I acknowledge that I am expected to arrive at the time that I selected. If I am late I will have to cover gratuity and will be charged a $75 late fee.

I acknowledge that ALL of my guests must arrive 30mins. early to avoid being charged for admission fee.

I acknowledge that being late can result in guests of your party being charged admission for entry.

I acknowledge that someone must be in the section within 30mins. of your reservation. If not, you lose your reservation and there will be NO REFUND.

I acknowledge that I have read, understand and am in agreement with these policies.

I acknowledge that by checking this box, I agree to receive notifications, updates, reminders & promotional messages to the phone number provided from Royal Peacock Lounge *

YES