Boyden VIP 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. I authorize Boyden Valley Winery to automatically charge my card on file every three months for my pre-selected cases of wine. I understand that if I would like to make any changes to my pre-selections, I must call at least 1 week prior to the 1st of the month in which my case is scheduled to ship. I understand that the $25 Membership Fee will be charged to my first order. My $25 membership fee will be credited back towards the purchase of my 4th case, and if I choose to re-join a new membership fee will be required. If my credit card is declined and I do not meet my 4 case commitment within 1 year of the specified date, my Membership fee is forfeited the $25 membership fee is non-refundable and any cases purchased will be retroactively calculated at 10% OFF and you will be responsible for paying the difference of the discount originally given. I will need to rejoin the Boyden VIP 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.