PRIZE ACCEPTANCE FORM

PRIZE: Trip to Louisville Kentucky USA for 1 person (travel dates dependent on point of departure. Departing 17th June 2017 from Sydney and arriving back into Sydney on 24th June 2017). Note: interstate winners must be available to depart 16th June and may return 25th June subject to flight availability at time of booking.

To be completed by the official prize-winner only. Form due date 24th March 2017.

Please enter 1076 followed by your surname eg. 1076Smith.
Waiver *
Please read and check all of the below boxes to agree to each of the conditions outlined. In submitting the form, the traveller confirms they understand the below conditions and confirm they meet all of the requirements. If you require clarification about any points or need any advice prior to completing this form please contact laura@33degrees.com.au or call 1300 861 800.
Exactly as it appears on your passport.
Exactly as it appears on your passport.
Exactly as it appears on your passport.
DD/MM/YYYY
It is important to check that your passport has at least 6 months validity from the planned date of return to Australia and several blank pages.
It is the responsibility of the winner to update 33 Degrees (travel coordinator) if there is a change to any contact details provided in this form (especially mobile phone contact number). You may wish to secure a travel sim for cost-effective international calling rates. It is important that 33 Degrees has a current mobile phone number for all travellers to ensure that contact can be made at any time throughout the travel period. Please ensure that international roaming is activated prior to departure if relevant. Please speak to your phone carrier about international data charges.
If relevant
Eg. pregnancy or physical disability requiring special assistance. If none, please type 'None'. It is advisable to see a doctor prior to travel to discuss travel health issues. Check that your medications are legal at your destination by contacting the embassy or consulate or speaking with your doctor. You may wish to consider carrying a letter from your doctor detailing what your medicine is, and that it is for personal use.
For emergency use only
For emergency use only
For emergency use only
For emergency use only
Information relating to entry/exit requirements for travel to USA can be found at http://www.cbp.gov/travel/international-visitors/esta. Please choose from the following 3 options: Option 1: I meet the requirements of the visa waiver program (VWP) for entry into the USA and I understand that obtaining an ESTA is my responsibility and at my expense and I will provide a copy of my ESTA to 33 Degrees by 14 April 2017. Option 2: I do not meet the requirements of VWP and I understand that securing the relevant visa is my responsibility and at my expense and I understand that I must provide a copy of the visa to 33 Degrees by 14 April 2017. Failing to meet these deadlines will result in the prize being forfeited. Option 3: I am travelling on a US passport and do not require an ESTA or visa.
Available at the end of the current itinerary dates only, subject to availability. If yes, please provide requested dates under "preferred travel dates" head below. (Return date MAY be amended. Departure dates MAY NOT be amended).
Your trip includes travel departing 17 June 2017 returning to Australia 25 June 2017. You will stay in the US for 4 nights (in 18 out 22 June) and you lose a day on the way home due to crossing the international dateline. If you wish to extend your stay in the US (at your expense) please provide a clear request here to enable us to provide a quote. Please note that a $150 fee applies to provide a quote to extend. If you do not wish to extend your trip please enter 'no extension required'