Please choose club level:




HOLIDAY MAGNUM CLUB

Once you are set up as an "official" Black Chicken Society member, you may request consideration for our very limited members only Holiday Magnum Club option. Please contact us directly at (707) 257-7555 to inquire as to how you can add this feature to your membership.

 

Please note that fields marked with * are required:

* Member First Name:
* Member Last Name:
* Date of Birth:
 (MM/DD/YY)
* Email Address:
* Password:
(8 character minimum,
with at least one number
and one letter)

  Shipping Address:

Company Name:
* Street Address 1:
Street Address 2:
* City:
* State:
* Zip:

  Billing Address:
Use my shipping address for my mailing address - they're the same

* First Name:
* Last Name:
Company Name:
* Street Address 1:
Street Address 2:
* City:
* State:
* Zip:
* Daytime Phone:
Evening Phone:
Fax:

Checking this box attests to the purchaser's age as 21 years old or older. This also indicates that the purchaser accepts the shipping policies and membership policies below.
I agree to receive 4/8/12 bottles per shipment 2/4 times a year. I understand that cancellation of my membership before receiving a minimum of 2 shipments will result in the charge of all previous discounts applied to my account.

  Credit Card Information: Reload Credit Card Form