PRIZE ACCEPTANCE FORM

To be completed by the official prize winner only.

This number was provided to you when you were notified that you won a prize and starts with a 4-digit number followed by your surname. If you cannot locate this reference number please contact 33 Degrees prior to submitting this form.
Exactly as it appears on your passport (international travel) or drivers licence (domestic travel)
Exactly as it appears on your passport (international travel) or drivers licence (domestic travel)
Exactly as it appears on your passport (international travel) or drivers licence (domestic travel)
Licence number, state of issue, expiry date
Full name, contact mobile number and email
Amendments and cancellation *
Waiver *
Please check boxes to agree to each of the conditions outlined below