First Name: * Last Name: * Email: * Address Line 1: Address Line 2: City: State: —Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip: Birthdate: * Favorite Location: * AddisonAlpharettaAnaheimAnchorageAtlanta I (Buckhead)BeavertonBethesda IIBoca RatonBroomfieldBurlingameCarlsbadChandlerCherry HillChicagoCincinnati IClevelandColumbusConcordConroeCoral GablesCoral SpringsCupertinoDallasDearbornDenverDowneyDullesEdisonEncinoFarmington HillsFort LauderdaleHouston I (Downtown)Houston II WestheimerIndianapolisKey WestLas ColinasLas VegasLas Vegas – Westgate Resort and CasinoLombardMall Of AmericaManhassetMaple GroveMemphisMiami BeachMilwaukeeMinneapolisMiramarMontereyNewport BeachNorth Little RockNY WestOntarioOrlando - International DriveOrlando - Lake Buena Vista (Disney Springs Area)PittsburghPlanoPlymouth MeetingPuente HillsSalt Lake CitySan DiegoSan FranciscoSan MateoSanta AnitaSanta MonicaSchaumburgScottsdaleShort HillsStuartSugar LandTemeculaTorranceTroyWestburyWheelingWoodlands Phone: * Are you male or female? Identify MaleIdentify FemalePrefer not to answer When do you usually visit Benihana? (check all that apply) LunchDinnerHappy HourTake-out or DeliveryCatering How often do you visit Benihana? —Please choose an option—Once a MonthOnce Every 2-3 MonthsOnce Every 3-6 MonthsOnce Every 6-12 MonthsEvery Year For Your BirthdayRarely/Never What are your favorite types of dishes on our menu? ChickenLobsterScallopsShrimpSalmonSteakSushiTunaVegetarian Which alcoholic beverages do you enjoy the most at Benihana? WineSakeSpecialty CocktailsBeerI do not drink alcohol at Benihana When do you enjoy dining at Benihana? Special OccasionsFamily DinnerDinner with FriendsDate NightHappy HourBusinessOther Kabuki Kids Celebrate the child in your life! Enroll them into our exclusive Benihana Kabuki Kids® program, just for kids ages 12 and younger. Members receive a special email certificate for their birthday that entitles them to a free souvenir mug of their choice with the purchase of any Kabuki Kids® meal. First Name: * Last Name: * Birthdate: * Remove Child Add Child instagram facebook tiktok
