Case Club Date* Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* Untitled* I understand that I am committing to purchasing 4 cases (12 bottles each) of wine within 1 year from the date on this form. My first order must be a minimum of 12 bottles, and a $25 Membership Fee will be applied to my first order. I may choose to receive my $25 membership fee back towards the purchase of my 4th case, but it will automatically be rolled into an additional year of membership if not specified. If I do not meet my 4 case commitment within 1 year of the specified date, my Membership fee is forfeited, and I will need to rejoin the club with a new membership fee if I wish to join again at a future date. I also understand that my membership does not include discounts on ciders, spirits, or 50ml mini bottles.