Wine Club Enrollment Form

Name *
Address *
City *
State *
Zip Code *
Telephone *
Email *
Wine Preferences (mark all that apply):
Classic Dry White
Off-Dry White
Desert / Sweet White
Classic Dry Red
Off-Dry Red
Desert / Sweet Red
Rose / Blush
Meritus
Tempranillo
Reserve Wines
My signature certifies that I am 21 years of age, or older. By signing this I authorize Fall Creek to enroll me in "Friends of Fall Creek". As a member I will receive 6 shipments throughout the year. Each shipment will consist of 3 bottles of wine with an approximate cost of $50 per shipment (includes shipping and handling). I understand I may cancel my membership at any time by giving a two week notice.
* = Required

Web Hosting Companies