Certificate Request Form

Voucher Code:
Name (First, Last):  
City, State, Zip:   
Primary Phone:
Secondary Phone:
Email Address:

   By checking this box you agree to the terms and conditions listed below.


Terms and Conditions

  1. This mail-in offer provides dining certificates of US$25.00 each. One request may be issued each month for sixteen months. Return this completed request form with a self-addressed, postage paid envelope to : USA DINE-AROUND.COM LLC, 4301 N.Ocean Blvd. Suite 1107 Boca Raton, FL 33431. in order to receive your dining certificates. Requests will commence upon payment from the daily deal site.
  2. This offer is invalid where prohibited by law, if used in conjunction with or in place of any other promotional offer or discount. All federal, state and local laws apply. USA Dine-Around.Com LLC. assumes no responsibility for any verbal or written representations made in conjunction with this offer other than those specifically included in this offer, nor for any damage, expense, inconvenience, loss, injury, death, delay, mechanical breakdown, strike, act of God, or any other circumstances beyond its control. USA Dine-Around.Com LLC. reserves the right to substitute the components of the offer should circumstances so require.
  3. This offer has no cash value. This offer is nontransferable, is valid for sixteen months from date of purchase and all requests must be received by USA Dine-Around.Com LLC. within that time. Customer consents to be bound by all the terms and provisions contained within the offer. USA Dine-Around.Com LLC. reserves the right to change these terms and conditions without notice. Please contact USA Dine-Around.Com LLC. with any questions at 954-840-8048, between the hours of 9:00 a.m. and 6:00 p.m. EST.


I have read, understand and agree to the terms and conditions of this offer.Incomplete or improper submissions invalidate this offer and will not be returned.