Special Function Request

Please complete this online form and we will review it and call you back to discuss the event further.  Submitting this request is not a guarantee of a scheduling.  If the requested date is available we will then require a $300 deposit to reserve the date.  Deposit will not be refunded if cancelled.

* Required fields
Name *
E-mail Address *
Phone Numbers *
Date of Event *
Time of Event *
Lot Number (or name of owner/sponsor) *
Number to Attend *
Type of Event *
Room Desired *

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Hide-A-Way Lake Club, Inc.  *  601-798-1484  *  Fax 601-798-0604
P.O. Box 1011  *  Picayune, MS  39466