CC Authorization CC Authentication Name (as it appears on credit card) *Email Address *Phone *Payment/Card Type *Select Payment/Card TypeVisaMasterCardAmerican ExpressDiscoverCashCheckCredit Card Number *Expiration Date *Street Address *City *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People’s Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d’IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People’s Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweAny food restrictions? *VeganVegitarianGluten FreeNoneOtherEventsMeet the Wine Maker – 11/10/2023 – 6:00 pm – 9:00 pmMeet the Wine Maker No. of TicketsKickoff Cocktail Party – 12/10/2023 – 6:30 pm – 10:00 pmKickoff Cocktail Party No. of TicketsWomen of Wine Lunch – 13/10/2023 – 12:30 pm – 2:00 pmWomen of Wine Lunch No. of TicketsTCI Food Festival – 13/10/2023 – 6:00 pm – 10:00 pmTCI Food Festival No. of TicketsWine Pairing Experience – 1st Seating – 14/10/2023 – 11:45 amWine Pairing Experience – 1st Seating No. of TicketsWine Pairing Experience – 2nd Seating – 14/10/2023 – 1:15 pmWine Pairing Experience – 2nd Seating No. of TicketsCulinary Trends Symposium – 14/10/2023 – 2:30 pm – 3:30 pmCulinary Trends No. of TicketsFour Course Wine Dinner & Cocktails – 14/10/2023 – 6:30 pmFour Course Wine Dinner No. of TicketsSunday Brunch – 1st Seating – 15/10/2023 – 11:30 amSunday Brunch – 1st Seating No. of TicketsSunday Brunch – 2nd Seating – 15/10/2023 – 1:30 pmSunday Brunch – 2nd Seating No. of TicketsTotalI certify that I am the authorized signer of the Credit Card listed above. *I understand that all event cancellations have to be made at least 5 days prior to the event and I will be liable for the full amount if cancellations are not made at least 5 days in advance. I certify that all information is complete and accurate. I hereby authorize Grace Bay Club, on behalf of the 13th Annual Caribbean Food and Wine Festival to collect payment for all charges as indicated in the Total Cost section of this form by processing a charge to the Credit Card listed above.Register
