RHR Wine Club Sign-Up Form

RHR Wine Club Sign-Up Form

Name, Store Login, and Billing Information
First Name	•	Middle Initial
Last Name	•
Daytime Phone	•
Email Address	•
RHR Store Login ID *
* note: if you do not have a store account or you do not know your login ID, please leave blank.
Billing Address 1	•
Billing Address 2
City	•
State	•
Zip	•

• denotes a required field

Shipping Information

Shipping address is same as billing address

Shipping Address 1

Shipping Address 2

City

State

Zip

Important Note: Your store account will be created/updated to reflect the shipping address above. You can then update your RHR account profile and shipping address at any time.

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	By checking this box, I certify that I am 21 years or older, and understand that at delivery an adult must sign for the wine. I authorize RHR to charge the above credit card for two annual shipments of six bottles each of wine, plus applicable sales tax and shipping.

Should you wish to cancel your membership in the RHR Wine Club, you may do so at any time by notifying us in writing or via email at least thirty (30) days prior to a shipment date.