Birthday/AnniversaryClub

Birthday/Anniversary Club

We invite you to celebrate your birthday or anniversary
 at our restaurant with a free meal 
(up to $15 in value). 
 
Birthdate/Anniversary
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Day Phone:
Evening Phone:
Email:
Comments:

Captain Larry's Seafood House 
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