By my signature, I indemnify Vortex Competitions Ltd for any loss which may
result if any of the foregoing information is not true and accurate.
Under penalty of perjury, I declare that to the best of my knowledge and belief:
1. The name and address which I have provided, correctly identify me as the
recipient of this payment
2. No other person is entitled to claim this prize
3. I am not a person disqualified by law from claiming and/or accepting this prize
4. I am over 18 years of age