gin-quarterly-enrollment-form

WHISKY MASTERS ENROLLMENT FORM

As members of our first subscription spirit offering, you'll receive an exclusive bottle of gin every quarter. Your gin will be packaged with details of the gin along with tasting notes and cocktail suggestions and will be available for pickup from the restaurant. Club Members will also receive priority access to tasting events as well as discounts on online orders from our website.

First Name (Required)

Last Name (Required)

Email Address (Required)

Phone Number

000-000-0000 or (000) 000-0000

Comments

SUBSCRIPTION OPTIONS

Members may sign up for as many subscriptions as they'd like however under local liquor regulations, we are limited to distributing a maximum of 2 bottles of wine per guest per day so multiple pickup visits may be required for multiple subscriptions.

WHISKY Masters (varies between $89-$169 per bottle depending on the expression b

1 Bottle every Quarter - Ongoing (cancel anytime)

CHOOSE YOUR PREFERRED STARTING MONTH

March

June

September

December

Earliest Available

MAKE IT A GIFT SUBSCRIPTION (Optional)

1 Month Gift Subscription

2 Month Gift Subscription

3 Month Gift Subscription

6 Month Gift Subscription

12 Month Gift Subscription

Ongoing until I Choose to Cancel

Gift Recipient's Name (if applicable)

Gift Recipient's Phone (if applicable)

Gift Recipient's Email (if applicable)

Credit Card Type

Visa

Mastercard

American Express

Name on Card

Card Number

Expiration Date

3-digit CVD

Has one of our servers or wine club members referred to? Please let us know who.

Authorization

I hereby authorize Copperhouse Eatery + Lounge to charge my credit card at the beginning of every month for the subscription amount plus GST. I understand that I may cancel my subscription at any time before the 20th day of the preceding month by sending an email requesting cancellation to wine@copperhouse.ca.

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