this is an order request form

This form is to request a keg or kegs for pickup as we are unable to offer delivery at this time. This ensures prompt pickup for you and accurate records for us! Win win! Order requests made with this form must be done at least 72 hours in advance and must be confirmed by our staff before it’s secured. You’ll hear from us within 48 hours.

Identification will be required upon pickup and must match the identification information provided below. Thank You!

Pickup Location:

The Vanguard Brewpub & Distillery

504 N. King Street, Hampton, VA 2366

Purchaser's Name

First Name

Last Name

Purchaser's Date of Birth

YYYY

Purchaser's ID #

Purchaser's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Purchaser's Email

Purchaser's Phone #

(###)

###

####

At what address will you be enjoying the keg?

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

On what date will you be enjoying the keg?

YYYY

Beer 1

Beer 1 Type

Beer 1 Keg size

Beer 1 Keg quantity

Beer 2

Scroll to the bottom of the page and submit if not applicable.

Beer 2 Type

Beer 2 Keg size

Beer 2 Keg quantity

Beer 3

Scroll to the bottom of the page and submit if not applicable.

Beer 3 type

Beer 3 Keg size

Beer 3 Keg quantity

I understand this from is a request to place an order and must be confirmed by our staff before it's secured.

I understand

I understand the identification provided upon pickup must match the purchaser identification information provided in this form.

I understand

I attest to the following:

I understand the minimum legal age to purchase and consume alcohol in the state of Virginia is 21 years old.

All the information provided above regarding the age and identification of the purchaser is accurate.