Claim referral prize

Referral prize claim form

Fill this out to claim your prize.

This field is for validation purposes and should be left unchanged.

Full legal name(Required)

Email address used to enter(Required)

Which prize did you win?(Required)

Shipping details

Address(Required)

Street Address

Apartment, Suite, or Unit Number

City

State / Province

ZIP / Postal Code

Country

Phone number(Required)

Eligibility & agreements

Age verification(Required)

I certify that I am at least 18 years of age (or the age of majority in my jurisdiction).

Residency verification(Required)

I certify that I am a legal resident of my country/state and eligible to receive this prize.

Liability release(Required)

I agree to release WestStar Mutlimedia Entertainment from any liability, loss, or damage resulting from the acceptance or use of this prize.

Winner acceptance & release agreement(Required)

I confirm that I have read the Winner Acceptance & Release Agreement and understand and accept all terms contained within.

Final acceptance

Prize acceptance & confirmation(Required)

I acknowledge that providing false information will result in immediate disqualification. I confirm that the details above are accurate and I formally accept the prize in accordance with the giveaway rules.

(You must check this box to submit the form)

Have you seen The Current?

Referral prize claim form

Shipping details

Eligibility & agreements

Final acceptance