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*First Name:
*Last Name:
*Phone Number:
*Email Address:
Date:
Jan
Feb
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Dec
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2010
Time:
5
6
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8
9
:00
:15
:30
:45
AM
PM
Number of People:
2
3
4
5
6
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9
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12
Special requests:
Business Hours: Monday to Saturday 5 - 9 PM
Join Retro Bistro's Email Club
535 3rd Street Berthoud Colorado 80513 Phone: 970-532-4095
