Request for Reservations



Group (Wedding) Name:_______________________ Date of Function: ____________

Time: __________ Guest Attending: _____________

Person Responsible for Reservation:________________________  Phone Number: _______________

Dining Room (please circle): Carriage Room   Mr. Hogue Room    Gold Room   Veranda

Room Rental fee for the Carriage Room, Mr. Hogue Room, and Veranda is $500/2 hours

Room Rental fee for the Gold Room is $200/2 hours

In our private rooms only 2 hours rental included in fee

Would you like additional time in our room for $100/hour: Yes    or    No   How many?______

Would you like for us to serve local wines and beer with the function: Yes    or    No

Email for Confirmation: ______________________________   Date of submission:_______

**This is not a guarantee of reservation. You will receive an email confirmation of the reservation if the date and room is available.


Cardholder Name:_______________________________

Phone No:_____________________

Please identify credit card below (check one)

____ American Express            ____ MasterCard

____ Discover                         ____ Visa

Credit Card Account Number:  _________________________________________

Exp. Date ____________________  CVC Code ________  Zip Code _____________

Amount Charged on card:$Room Rental fee       Date of charge: ______________

I hereby authorize  THE SMITH HOUSE to apply costs for the above listed items/services to the credit card identified above.

Cardholder Signature ___________________________________________Date ___________

The room rental fee will be charged to the card provided. The same card associated with the event scheduled will be charged to the card above. The confirmed number of guest attending is the number charged for the event. It is the responsibility of the party to change the number 2-week in advance of the arrival date if the number is different than the booking number. A copy of the itemized bill can be picked up the night of the event at the front desk.

Email form to or  Fax  to 706-748-7377 an acknowledgment email will be sent about availability of reservation.