Primary Member *

First Name

Last Name

Member Birthdate *

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DD

YYYY

Day Phone *

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Cell Phone

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I would like to receive texts and news updates

Secondary Member

First Name

Last Name

Secondary Birthdate

MM

DD

YYYY

Address *

DUE TO STATE LAWS, WE ARE UNABLE TO SHIP SPIRITS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is the best time of day to contact you?

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Agreement *

I certify that I am at least 21 years of age. I authorize Chankaska Creek Ranch and Winery to charge my credit card for each shipment at the time of processing. I understand that my membership is for a minimum of twelve months. It will renew automatically unless I request cancellation in writing to the winery. All members will receive text, email and news updates. Member benefits will not activate until a credit card number is added to the account.

I Agree