Notice: Undefined index: in /home/goldenbearwines/public_html/wp-content/themes/wine/templates/page-part-postinfo.php on line 45 Wine Club Membership All fields are required. Once form is submitted, a Golden Bear Representative will then contact you to complete your membership. Your Name Address City State Zip Cell Phone Home/Work Phone Your Email Date of Birth (mm-dd-yyyy) Select Membership Cub Club Member - 3 bottlesGrizzly Club Member - 6 bottlesGolden Club Member - 12 bottles I certify that I'm 21 or over