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On The Record Nightclub Reservations Form
Upon submission of this form, you will be assigned an On The Record Nightclub host/ess who will provide the free guest list entry or VIP option prices for you and your group.
Requested date of reservation:
*
MM
/
DD
/
YYYY
FRI-SUN: 10:00pm-4am
Select your request:
Exclusive Guest List Free Entry
Bottle Service/Tables
Primary Contact Name
*
First
Last
Primary Contact Email
*
Primary Contact Phone
*
Number of Ladies to Attend
*
#
0
1
2
3
4
5
6
7
8
9
10
10+
Number of Guys to Attend
*
#
0
1
2
3
4
5
6
7
8
9
10
10+
Any questions or comments for your host/ess?:
Would you like to subscribe to our email newsletter of the most popular upcoming Las Vegas events and discounts?
Yes
No
