VIP Bottle Service Request Form

Ultra ($500)

Sun. Oct. 13 @ LUXY Nightclub
What's Included: ULTRA $500 | Tax & Tip Included 2 Ultra Premium Bottles Of Your Choice (Hennessy | Johnnie Walker Black) Complimentary Hookah Private Table VIP Service VIP Entrance Line By Pass | Tax and Tip Included

Please fill out the form below to request VIP & Bottle Service. A representative from the club will contact you to confirm your booking.

*Name (first & last) *Best Time to Call Best Way to Contact You

*Event Date

*Email Phone Number Number of People

*7+9=

Additional Notes Privacy Policy

VIP Bottle Service Request Form

Ultra ($500)

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