23 BISTRO KITCHEN AND BAR
VIP CUSTOMER CARD Membership Application
APPLICANT INFORMATION
Name:
Date of birth: Mobile #: Home Phone:
Address:
City: State: Post Code: 4876 or 4875
EMAIL Address
SPOUSE INFORMATION IF JOINT MEMBERSHIP
Name:
Date of birth: Mobile #: Phone:
EMAIL Address
SIGNATURES
I authorize that I am applying for a VIP Customer Card. In accordance with 23 Bistro privacy policy information provided will not
be shared with any other party. By requesting a VIP Customer Card I agree to receive promotional information by either email
or other means, I understand that I can un-subscribe at any time. The VIP customer card can only be used by the below
signatures.
Signature of applicant:
Date:
I have read and agree with the below TERMS & CONDITIONS
Signature of spouse (only if for a joint membership):
Date:
I have read and agree with the below TERMS & CONDITIONS
VIP Customer Card Signup - Terms and Conditions of Use
1. By applying for a 23 Bistro VIP Customer Card (VIP CC) you agree to be bound by these terms and
conditions as amended from time to time (Terms) and are subject to any other conditions imposed by 23
Bistro from time to time. The latest Terms supersede and replace any and all previous terms and conditions
in connection with the VIP CC
2. Only Individuals can apply to join the VIP Club by completing an application form and 23 Bistro may, in
its absolute discretion, accept or refuse any application.
3. A successful applicant may only hold one VIP CC card (Card).
4. Cardholder benefits are determined by 23 Bistro from time to time and may include discounts, invitations
to events, entry into promotions and are subject to availability.
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23 BISTRO KITCHEN AND BAR
5. Cardholder benefits only apply to the named Cardholder upon presentation of their Card and are non-
negotiable, non-transferable, not redeemable for cash and may not be used in conjunction with other offers
unless otherwise specified by 23 Bistro.
6. VIP CC are not debit, credit or charge cards and remain the property of 23 Bistro at all times. Cards must
be returned to 23 Bistro immediately upon demand by 23 Bistro.
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23 BISTRO KITCHEN AND BAR
7. Cards and benefits are valid until cancelled by 23 Bistro (in its absolute discretion) or until the Cardholder
notifies 23 Bistro that he or she wishes to terminate their membership. If your VIP CC membership or Card
is cancelled then you must return the Card to a 23 Bistro.
8. 23 Bistro may, in its absolute discretion, at any time, and without notice or reason, modify these Terms,
cancel or suspend any Card/membership or the VIP CC generally.
9. 23 Bistro is not responsible for stolen or lost Cards or Cards that are used fraudulently. The Cardholder
must report a stolen or lost Card to a 23 Bistro immediately. The Cardholder's existing Card will be
cancelled and a new Card issued.
10.23 Bistro shall not be liable in any way if benefits or promotions are unavailable for any reason including as
a result of a technical malfunction, operator fault, computer hardware or software errors.
[Link] a technical malfunction, operator fault, computer hardware or software error results in a discount being
overlooked or wrongly attributed, the Cardholder may bring this to the attention of staff at 23 Bistro within
24 hours of the time of the purchase to receive the appropriate discount.
12.23 Bistro is not liable in any way whatsoever for any injury or loss (including any indirect or consequential
loss) of any kind to person or property suffered by any Cardholder whether by reason of any act or omission,
deliberate or negligent, of 23 Bistro in connection with the VIP CC, including injury or loss incurred whilst
participating in any activity of the VIP CC or 23 Bistro or in any activity in which Cardholders are invited to
participate. This condition is subject to any liability which may not be lawfully excluded, in which case such
liability will be limited to the fullest extent permitted by law.
[Link] indemnify 23 Bistro for and against any loss or claim suffered or incurred by 23 Bistro arising
from or in connection with a breach of these Terms by a Cardholder or in connection with a Cardholder’s
Card.
OFFICE USE ONLY:
PROCESSED: ......................................................................................................
CUSTOMER NUMBER: ...............................................................................................
VIP CARD B/CODE:.....................................................................................................
DATE CARD SENT OR PRESENTED TO VIP CC: ......................................................
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