Lunch Roll Order Form
Order submissions are required 24hrs prior to the event. Lunch roll orders are non-refundable. Single order per day selected.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
A valid phone number throughout the event.
Boat Name
*
Sail Number
Event
*
E.g. Wednesday Race, Saturday Inshore, Sunday Centreboard
Team / Yacht Club
Optional
Event Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Payment Method
*
Credit Card
RPAYC Members' Account (Coupon - Mem-Acc)
Members Account Number
Only add if charging to your Club Account
Roll selection
Select Roll type & Quantity required
*
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next
( X )
Ham Roll
Ham, Cheese, Lettuce, Tomato, Mayonnaise
$8.50 AUD
$
8.50
AUD
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Item subtotal:
$0.00 AUD
$
0.00
AUD
Roast Chicken Roll
Roast Chicken, Lettuce, Mayonnaise
$8.50 AUD
$
8.50
AUD
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Item subtotal:
$0.00 AUD
$
0.00
AUD
Egg Roll
Egg & Lettuce
$8.50 AUD
$
8.50
AUD
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Item subtotal:
$0.00 AUD
$
0.00
AUD
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Dietary Requirement Options
Gluten Free
Vegetarian
Vegan
Dairy Free
Other
Special Dietary Requirement Notes
Terms
*
I agree to the above AUS $ to be charged to my nominated Credit Card or Members Account as listed.
** 1% surcharge applicable on credit card transactions. Visa and Mastercard only accepted. No refunds applicable.
Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Print
Submit
Should be Empty: