Friends of Miners Ridge Wine Club online form

Friends of Miners Ridge Wine Club

Membership form
Become a ‘Friend’ today and start taking advantage of the benefits.

As a ‘Friend of Miners Ridge’ you will receive a dozen curated wines every year in time for Christmas. Keep the curated pack or select your own by emailing your swaps out.

Your annual pack will deliver free of charge for $220.

Free deliveries on additional purchases throughout the year valued over $200. You will also receive 30% off additional wine purchases.
Are you over the age of 18? Please confirm your age in the box below.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Please select your choice of pack
Phone Number
Please enter a valid phone number.
Is shipping address same as billing address?

YesNo
Shipping Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you give authority for your delivery to be left somewhere if not home?

YesNo
If you gave authority for your delivery to be left, please add your preferred location. i.e front verandah, side of house etc.
Special Instructions
Please verify that you are human*
Once you have submitted your form, you will be contacted by Katrina from Miners Ridge Wines to confirm and organize payment details.
Should be Empty: