Membership Sign Up Form - 3 Horse Ranch Vineyards

LES TROIS VINS WINE CLUB MEMBERSHIP FORM
Please print this form, fill it out completely and mail to: 3 Horse Ranch Vineyards, Les Trois Vins Club, 5900 Pearl Road, Eagle,
Idaho 83616.
I would like to join Les Trois Vins Wine Club.
3 times a year, Les Trois Vins members will receive a selection of 3 Horse Ranch Vineyards wines ($45 to $65 per selection, 1
bottle of each wine) at the 15% Club discount. Tax and shipping not included.
Billing Address
Name
Company
Address
Address line 2
City/State/Zip
Phone (daytime)
E-mail
Date of Birth
________________________________
________________________________
________________________________
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________________________________
________________________________
________________________________
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Shipping Address
Same as Billing Address? YES
NO
Name
________________________________
Company
________________________________
Address
________________________________
Address line 2 ________________________________
City/State/Zip
________________________________
Phone (daytime) ________________________________
Please (check one)
Ship my wine selections. We do not ship wine to states prohibited by law.
Hold my wine selections for pick up at the 3 Horse Ranch Vineyards Tasting Room
Wine not picked up within 30 days of notification will be shipped at my expense when allowed by law.
Billing Information
Credit Card # ________________________________
Expires
________________________________
I certify that the member/recipient is at least 21 years of age and understand an adult signature is required for receipt of all
shipments.
My credit card will be billed prior to the shipment/pickup of wine. I may cancel my membership at anytime without further
obligation upon a written request (e-mail is acceptable) to 3 Horse Ranch Vineyards. Cancellations received less than one year of
membership date subject to $25.00 cancellation fee. Any shipments sent prior to receipt of my notice of cancellation will be billed
to my credit card. 3 Horse Ranch Vineyards is not responsible for any tax or shipping charges incurred.
(Cardholder’s signature REQUIRED)
Signature
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Print Name ________________________________
Date
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