Membership Sign-up - VIP Club San Miguel

First Name | Nombre(s) *

If you are a couple using one card, please include both first names in this field | Si son una pareja compartiendo una tarjeta, pon los dos nombres aquí

Last Name | Apellido(s) *

Would you like a card for your significant other for an additional cost ($500 cash/$600 cc)? | Te gustaria otra tarjeta para tu pareja por un costo adicional ($500 efectivo/$600 con tarjeta)?

Yes | Sí
No

If yes, what is the full name for the 2nd card? | Si, si cual es el nombre completo para la otra tarjeta?

Email *

Email

Confirm Email

Secondary Email (optional)

If you have two cards, please provide a second email address | Si tienen dos tarjetas pon el otro correo electrónico aquí

Cell Phone | Número Celular *

Please make sure to include the country code if your number is from outside of Mexico

Secondary Phone (optional)

Preferred Contact Method | Medio de Contacto Preferido *

Email
WhatsApp

Preferred Language | Idioma Preferida *

English
Español
No preference | Sin preferencia

Local Address | Dirección Local *

We just need the street name, number, and colonia | Solo calle, número, y colonia por favor

Preferred Method of Payment | Forma de Pago Preferida *

Cash | Efectivo
Credit or Debit Card | Tarjeta de Crédito o Débito
PayPal

Comments? Questions? | Comentarios? Preguntas? (optional)

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