*First Name

*Last Name

*Phone

*Email

*Date of Visit

*Number of Guests 1 2 3 4 5 6

*Time of Visit 10:00 am 10:30 am 11:00 am 11:30 am 12:00 pm 12:30 pm 1:00 pm 1:30 pm 2:00 pm 2:30 pm 3:00 pm 3:30 pm 4:00 pm

Are you a member of our Wine Club? Yes No

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