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Please reserve your place for the Wine Tasting by
using this PayPal button

and then sign up using the form below.

or

after filling out the form, you can send your donation check to:

ChildrenUP Wine Tasting
481 W. Alma Ave.
Elmhurst, IL 60126

Wine Tasting Sign Up Form

Kindly let us know which wine tasting session you plan to attend by checking the correct box.

A = 5 pm to 6 pm, B = 6:30 pm to 7:30 pm, C = 8 pm to 9 pm
(please indicate only one)

Name
Email address
Home phone
Cell phone
Home address
Wine Session (A / B / C - see above note)
Form of Payment   Payment is needed to insure your reservation
Unable to Attend Here is my donation for ChildrenUP