By completing this purchase, I hereby certify that I am an individual at least 21 years of age.

I agree to indemnify and hold harmless Neptune Wine and Liquors and its employees, contractors, directors, officers, agents, successors and assigns (collectively, the “Indemnified Parties”) against any and all claims, liabilities, investigations, sanctions, fines demands, damages, losses, expenses, rights and causes of action of any kind or nature arising out of or related to any misrepresentation that I am an individual of at least 21 years of age.

I further acknowledge that the consumption of alcoholic beverages carries inherent risks, including the risk of personal injury to myself and/or to others, and I hereby agree to indemnify and hold harmless each of the Indemnified Parties against any and all claims, liabilities, demands, damages, losses, expenses, rights and causes of action of any kind or nature arising out of or related to my consumption of any of the alcoholic beverages set forth on this receipt.

I certify that this is my credit card and I am in full posession and have the authority to use this for alcoholic beverage purchases.