Billing Name *

First Name

Last Name

Billing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mobile Phone Number

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Work Phone Number

(###)

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Shipping Name (if different than billing)

First Name

Last Name

Shipping Address (if different than billing)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

This is a gift membership

Terms and Conditions *

I certify the following: I am at least 21 years of age, wine shipments will automatically be charged to my credit card prior to each shipment, that I am aware the U.S. government requires an adult signature for all wine deliveries, that I am responsible for all costs incurred if my wine shipment is returned for redelivery. Credit cards will be charged within one month prior to the physical shipment of the wine. Club memberships can be cancelled at any time after the receipt of your first club shipment and with at least one month’s notice prior to any shipment “All alcoholic beverages are sold in California and title passes to the buyer at the time of sale and are non-refundable, this includes charitable and special event purchases.” Hoi Polloi LLC and Pagter Brothers Winery makes no representation to the legal rights of anyone to ship or import any wines into any state outside of California. By placing an order, you authorize Hoi Polloi LLC and Pagter Brothers Winery to act on your behalf to engage a common carrier to deliver your order to you. State liquor tax or excise tax may be charged depending on various local, state or international laws.

I agree to the terms and conditions