PRIZE ACCEPTANCE FORM

PRIZE: Trip to Louisville Kentucky USA for 1 person (travel dates 15 Jul to 21 Jul 2016 ex Sydney). 

To be completed by the official prize-winner only. Form due date 7 June 2016.

Please enter 33D1074 followed by your surname eg. 33D1074Smith.
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
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 15 June 2016. 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 8 Jul 2016. 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.