





|  Blue Moon Restaurant    
             26 North Park Avenue Rockville Centre NY 11570  Telephone 516-763-4900  | 
                        
Customer Name: _____________________ Date of function:___________________ Time: ______________ Cell number: ____________ Home Tel: ____________________ Adults: ____________ Kids: ________________ Occasion : _______________________ Front Room: _____ Back room:_____ Main dining room:______ To be decided  | 
                        
| *** Gold Family Style Package*** | 
| 1 st course  | 
                        
| Choose 2 Appetizers:  Baked Clams, Mussels Marinara, Caesar Salad, House Salad, Cold Antipasto, Margarita Pizza, Fried calamari, Blue Moon Salad. (Additional appetizer $ more) To Substitute Hot Antipasto (Stuffed Mushrooms, Shrimp Oreganata, Baked Clams, eggplant Rollatini), add $ more person  | 
                        
* 2nd course Family Style***   | 
                        
| Kids menu under 10 $ per person Choose 2 Chicken Finger & fries, Pizza or Pasta | 
|  Today’s Date:________________  Price Per Person:__________________  Tax:_________ Gratuity:_______ Deposit is Non Refundable:______________________ Room Change: Tax Exempt: Yes or No Customer Signature:____________________ Note: Minimum of 40 adults needed for a private party room Note: In response to the shifting landscape of the restaurant industry, we will be implementing a 4% surcharge for all customers wishing to pay with credit or debit cards.  | 
