Adopt-A-Vine Club

Application form

Please print this form, fill it out and either:

* Fax it to us on 01883 743847 [or +44 (0)1883 743847 if faxing from outside the UK]

* Post it to us at the following address (enclosing your remittance):

Mrs Kate Deeley
81, Pathfield Road,
Streatham,
London, SW16 5PA.

* Call us on 01883 744590 during shop opening hours and place your order by phone

If you are applying from outside the UK, please fax your order to us.

Applications for Club membership may also be made in person at the Vineyard Shop (please check our opening times prior to visiting)

Subscription

Subscription charges as from 1st January 2011
(Fixed for the periods as shown below)

1-year membership	£20.00
2-year membership	£38.00

I would like to adopt________Vine(s)
please insert number of vines required.

I would like to adopt the Vine(s) for________years
please insert number of years.

I understand that each vine adopted entitles the named person to one bottle of wine for each adoptive year, which must be collected from the Vineyard within 2 months of notification. I understand that Godstone Vineyard will select the vine(s). I agree to abide by the conditions of the offer as listed at the bottom of this application form.

Signature______________________________________________________

Name (printed)_________________________________________________

Date___________________________________________________________

Payment method (please tick as appropriate)

I attach a Cheque (payable to Godstone Vineyards) / Cash / Postal Order

Please charge the sum below to my VISA / DELTA / MASTERCARD (please delete as applicable). Personal callers may also pay by SWITCH. We do not accept American Express.

Credit/Debit Card number________________________________________

Expiry date____________________________

TOTAL COST____________________________

Cardholder's Name and Address:

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Adoption details

Please write the name you would like on the vine's plaque:
(Maximum 30 characters, including spaces)

__________________________________________________________________

__________________________________________________________________

Please write the name you would like on the Certificate and Membership Card:

__________________________________________________________________

Please write any message you would like on the Certificate:
e.g. Merry Christmas! Happy Birthday! Happy Anniversary! (Maximum 30 characters, including adoption name). Remember you may want to say who the gift is from.

__________________________________________________________________

__________________________________________________________________

Your name and address:

Name: _____________________________________________________________

Address: ___________________________________________________________

__________________________________________________________________

________________________________Telephone: _________________________

The name and address of the person who will adopt the vine and who will receive the newsletters (i.e. the person who you are giving the adopt-a-vine to):

Name:_____________________________________________________________

Address: ___________________________________________________________

__________________________________________________________________

Email: ___________________________________________________________

Please answer this question:

I would like the initial mailing, being the membership card and certificate, to be sent to:

□ Me

□ The person to whom I am giving the adopt-a-vine

__________________________________________________________________

What happens next

After we have received the completed application form you should allow:

TWENTY FIVE WORKING DAYS to receive the Certificate and Membership Card.

THIRTY WORKING DAYS before your weatherproof name plaque will be in position on your vine.

CONDITIONS OF THE OFFER: 1. The fees are as shown on this application form. Payment in no way constitutes a purchase of or part payment of the vine. Godstone Vineyards reserves the right to change the subscription fees for new subscribers as they see fit. However, membership for a fixed-term will incur no further costs on the part of the subscriber. 2. Godstone Vineyards will retain full control over all the vines, the land, the grapes and the wine produced. 3. Adoption of a vine does not confer any rights over the vine, its maintenance and care, the grapes, the wine it produces or the land it occupies. 4. Godstone Vineyards will, in good faith, select a vine for you, but cannot be held responsible if the vine fails to perform to expectations. However, we will replace a vine that dies through natural causes. 5. Godstone Vineyards reserve the right to cultivate and manage vines as they see fit. 6. Godstone Vineyards will determine the harvest time and you will be notified as to the dates; if you are unable to pick the grapes when recommended, Godstone Vineyards will reserve the right to harvest them (you will still receive your bottle of wine). 7. Godstone Vineyards reserve the right to refuse entry for whatever reason may be found necessary. 8. Wine from your vine must be collected from the Vineyard.

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