Curtis Winery Order Form and Cellar Crew Enrollment Form

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Curtis Winery Order Form and Cellar Crew Enrollment Form

If you would like to join our Curtis Cellar Crew wine club and/or place an order for wines to be shipped, please print this page and fax along with proof of age to: (805) 686-99568 or mail to: Curtis Winery; Attention Elizabeth; PO Box 1299, Buellton, CA 93427.
Phone orders are also welcome: Toll Free 1-805-686-8999 x 2.

• I wish to order wine as a new or existing Cellar Crew member under the name of:_______________________

• Please enroll me in the Curtis Cellar Crew wine club. I will wait for the next shipment of wine.

• I select _____ 2 bottles_____6 bottles_____ 12 bottles per shipment.

• I would like to only receive red wine. ______

(Current Cellar Crew members only need to provide your name if all other information is current).

Name: _______________________________________________________________

Billing address:_________________________________________________________

City:_____________________________________ State:______ Zip:______________

Day Time Phone: (________) _____________________________________________

Email address:_________________________________________________________

Credit card: ______ Visa ______ Mastercard______ American Express______ Discover
(Must be 21 years old to join and receive wine. Void in states where prohibited by law.)

Card number: ______________________________ Exp Date: ___________________

Signature: _____________________________________________________
(Must be 21 years old to join and receive wine. Void in states where prohibited by law.)
Ship To: (complete if different from above. Adult signature required upon delivery):

Name: _______________________________________________________________

Shipping address: _______________________________________________________

City: _____________________________________State: __________ Zip: _________

Special Instructions or Message to include: _____________________________________________________________

FINE PRINT

Members are responsible for all shipping charges, including shipments that are refused, returned or shipped to an old address. You may cancel your membership anytime. However, if you cancel before receiving your first year’s wine shipment, you will be charged a $50 administrative fee. Not all states allow direct shipment of wine to residents. We can only legally offer memberships with shipping addresses in the following states: California, Colorado, Idaho, Illinois, Iowa, Minnesota, Missouri, Nevada, New Mexico, New York, North Dakota, Ohio, Oregon, Texas, Washington, West Virginia, Wisconsin and Wyoming.

If you do not live in one of these states, we may have a distributor of our wines in your state—give us a call for listings.