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Ladies VIP Card Form

Instructions: Please complete the following form to be sign up for the opportunity to win an exclusive VIP Ladies Card for Havana Club.

The VIP escape card entitles you and 3 female guests to complimentary admission, VIP entry, no wait in line FOREVER. Free valet parking before 10pm & Special invitations to exclusive VIP membeer events. Share this for more chances to win:

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Ladies VIP Card Form
Full Name: *
Birthday: *

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Email *
Phone Number *

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Submit Picture (jpg) *
Please upload your most recent picture here
Why would you like to be a VIP member of Havana Club? *

 

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