Cider Club Sign‐Up Form Member Benefits:       Free membership 15% discount Quarterly cider delivery (or pick –up) Tasting notes and suggested pairings Member only events and reservation discounts Unlimited free tastings for you and 1 guest Cider Preferences: (check all that apply) _____ Sparkling _____ Still _____ Seasonal _____ Oak Aged _____ Specialty Club Level: (select one) _____ 2 bottles _____ 4 bottles _____ 6 bottles _____ Full case _____ Pick‐Up at Orchard _____ Delivery Billing Information: Name: _______________________________ (As it appears on card) Birth Date: ________________ Email: __________________________________________ mm/dd/yyyy Phone: ___________________ Address: _____________________________________________________________________________ Street Shipping: (if different from above) ____________________________________________________________________________ Shipping is available to the following states: Alaska, Florida, Idaho, Missouri, Nebraska, Nevada, New City State Zip Code Hampshire, New Mexico, North Dakota, Ohio, Oregon, Virginia, Washington D.C., and West Virginia Address: _____________________________________________________________________________ Street _____________________________________________________________________________ City State Zip Code Turn Over My signature below certifies the following: * I am an adult of 21 years of age or older and have read and understand the terms of membership  I have elected to receive 2, 4, 6, or 12 bottles * I authorize Distillery Lane Ciderworks to automatically charge my credit card on each quarterly release date (Feb, May, Aug, Nov) for the amount of each cider, less the 15% discount, plus any applicable taxes and shipping fees. Fees will be charged automatically at the end of the month of each quarter. For MD, charges will appear through our third party register system Square. For out-of-state shipping, charges will appear through our third party system VinoShipper. An email will be sent to you from DLC notifying you that the payment has been made and that the shipment/pick-up is ready. * I understand my participation in the Cider Club is ongoing until I chose to cancel * I may cancel after the third release date by notifying Distillery Lane Ciderworks via email at [email protected] no less than one month prior to the next release date. * I understand it is my responsibility to inform DLC of changes to my contact information, shipping address, and billing information. * I understand delivery schedules are subject to change (i.e. severe weather). Returned or redirected shipments will result in incurred fees being charged to the next quarter’s delivery. *DLC will make three attempts to notify me of pick-up before a late fee of $25 will be charged to the next quarter’s pick-up. * I understand that the DLC Cider Club applies only to the hard cider produced at the cidery * It is legal to ship wine to the shipping address I have provided * If I do not like a cider, it is my responsibility to notify DLC at [email protected] so that it will not be included in future shipments. I understand that I cannot return an empty bottle of cider for exchange or refund. If I receive a cider that I have requested not be included, I may return that bottle prior to opening. In the event that I believe something to be wrong with my cider, I will notify DLC either by email and/or bring the bottle in question back to the cidery for an exchange. Signature Date