Event Wine Tasting Registration Form
Event Payment Note
If you are registering for an event that requires a registration fee, a wine consultant will contact you to gather your credit card information via the telephone. DO NOT include any credit card information in this registration form.
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| Name * |
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| Address * |
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| City * |
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| State * |
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| Zip Code * |
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| Daytime Phone |
(include area code) |
| Evening Phone |
(include area code) |
| Email * |
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Type the Date, Time and Location you are interested in attending.
ex: Ramada Suites Rockford Nov 10th 2PM
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| Your Party has how many attending?
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| Have you attended a PRP Event Before? *Yes No
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Are you and all of your guests over 21? *Yes No |
Do you have a PRP Wine Consultant?
If yes, what is your consultant's name?
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Legal Disclaimer
You must be 21 years or older to participate in PRP Wine tastings and events. Offer limited to the states that we have wine consultants in: California, Colorado, Florida, Illinois, Indiana, Michigan, Missouri, and Wisconsin. This offer is void, where prohibited, taxed or restricted by law. We reserve the right to substitute a gift of equal or greater value. This is not an inducement to buy, but to show our appreciation for your support over the years. Limit one gift per household. In California, Missouri, Michigan and Wisconsin, state law requires a nominal charge of $5.00 for the recipient of the gift.
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