DATE NIGHT PACKAGE ORDER FORM

DATE NIGHT PACKAGES WILL BE DELIVERED ON FRIDAYS. PLEASE PLACE YOUR ORDER EACH WEEK BY WEDNESDAY AT 10PM TO ENSURE DELIVERY.

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TWO DELICIOUS CHEESE, CHARCUTERIE OR CRUDITES BOXES WITH LOCAL RED BEE HONEYCOMB, JAM, AND SEASONAL FRUITS WITH YOUR CHOICE OF COCKTAIL KIT FOR 2 (4 DRINKS) PROVIDED BY QUEENIE’S COCKTAIL BAR

MOCKTAILS

COCKTAILS

Name

First Name

Last Name

Phone

(###)

###

####

Delivery Date

DELIVERIES ON FRIDAYS ONLY. FOR OTHER REQUESTS, PLEASE MAKE A COMMENT IN THE BOX AT THE BOTTOM OF THE FORM.

YYYY

Delivery Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Graze Box 1

choose one

Graze Box 2

choose one

Cocktail Kit

choose one (for full descriptions see above)

I am aged 21+ and will provide valid photo ID

A valid ID must be shown upon delivery

Yes

To complete your order:

We will send a notification to the listed email, please read, sign and return. Orders will not be placed until this is complete. Once we receive your signed notification, we will contact you for payment - via Venmo, Cash App or Square (credit card). Cocktail Kits including charcuterie for 2 people is $65. Delivery is calculated on location - approx $5-$25. If you have any questions please ask below.