#WLDCommunity Home Cocktail Video Contest Form
Name
*
First Name
Last Name
Email
*
yourname@example.com
Instagram Handle Used For Entry
*
Handle Name
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Confirm Your Age
*
-
Month
-
Day
Year
Must Be 18+ To Enter
Upload Your Video File Here
*
Browse Files
Drag and drop files here
Choose a file
.mp4 or .mov file type preferred
Cancel
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Submit
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