Coaster Club member 1 name *

Member name

First Name

Last Name

Coaster Club member 1 Phone *

Primary contact number

(###)

###

####

Member 1 Birthday *

We want to celebrate your birthday! And make sure you're over 21

MM

DD

YYYY

Coaster Club member 2 name *

First Name

Last Name

Coaster Club member 2 phone *

(###)

###

####

Member 2 Birthday *

We want to celebrate your birthday! And make sure you're over 21

MM

DD

YYYY

Coaster Club members only facebook group *

Our default method of communication is e-mail. Would you like to be added to our members only facebook page also?

Yes, add Member 1

Yes, add Member 2

No thanks, e-mail is fine

Mailing Address *

Mailing address so we can send you something around the holidays!

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Growler Gift options *

Please select one option

Classic - Engraved Glass Growler

Metal - Metal Insulated Growler with swingtop lid and CC tag + $30

Recycle - no new growler, but get 2 free growler fills instead

Payment method *

Your membership is valid once your payment is processed

In-person - during open hours

Online - you'll see the link for payment at our Square store after you click "submit"