Group Request Form

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Name *

First

Last

Email *

Phone

Organization Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Nature of Event

Social
Business

Event Type *

Spa
Dining
Overnight
Meeting
Wedding
Other

Check all that apply

Event Name *

Number of Attendees *

Event Description *

Arrival Date *

Departure Date *

Alternate Arrival Date

Alternate Departure Date

Do you require a private banquet room? *

Yes
No

Set-up Type

Classroom
Conference
Theater
Rounds
Cocktail

Do you require break-out room?

Yes
No

If so, how many break-out rooms per day?

Guest Room Type

Standard
Club Suite
Theater
Rounds
Cocktail

Check Applicable Food and Beveage needs

Breakfast
Lunch
Dinner
Reception
AM/PM Break

Name

Location & Contact
Information

46 W Market St, Rhinebeck, NY 12572
877-MIRBEAU (647-2328)
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properties

ALBANY, NY
SKANEATELES, NY
PLYMOUTH, MA

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