VIPClub.htm

Enjoy two different Chrysalis Vineyards wines every month! As a Club Member you will be part of a growing number of local and national wine enthusiasts who share an excitement about Chrysalis Vineyards wine. Print this page and fill out the form. Then fax to: 540-687-8666 –or– Call Ashley White at 540-687-8222, Ext. 205 –or– email completed form to AWhite@ChrysalisWine.com.

***Someone of the age 21 or older must be available to sign for each delivery***

Name: Daytime Phone: ( )

Email Address:

Shipping Address:

Billing Address:

Credit Card #: Expiration Date:

I agree to join Chrysalis Vineyards VIP Wine Club; I authorize Chrysalis Vineyards to charge my credit card in accordance with the membership I have signed below. I understand I am responsible for payment of all applicable state and local taxes. It is the customer’s obligation to notify Chrysalis Vineyards of any address changes, or cancellation, before the wines are shipped. Chrysalis Vineyards is not responsible for shipping charges incurred due to misdirected wines.

Signature:

Date:

Please fax to: 540-687-8666 –or– Call Ashley White 540-687-8222, Ext. 205 –or– email completed form to Ashley White