Please complete a separate form for each diner if their menu selections are different.
Full Name
*
First Name
Last Name
Email
example@example.com
Phone Number
Menu Selection
Images are for illustration purposes only. Actual dishes may vary in appearance.
Appetizer
Menu
Butternut Squash and Bacon Crostini (served with your choice of the options below)
Select one
*
Harvest Salad
Broccoli and Cheddar Soup
Main
Menu
Side: Maple-Roasted Corn (served with your choice of the options below)
Select one
*
Pumpkin Ravioli
Apple and Brie Stuffed Chicken Breast
Dessert
Menu
Select one
*
Fried Apple Rings
Raspberry Yoghurt Crumble Slice
Any dietary considerations?
Ticket Booking
(E-transfer payments, please contact Mel at 519-652-9778 ext. 222 or email mel@larchelondon.org)
My Products
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Adult
$
55.00
CAD
Quantity
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2
3
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5
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9
10
Child
12 years and under
$
30.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
Submit
General Enquiries
Mel Quevillon I Phone: (519) 652-9778 I Email: mel@larchelondon.org
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