Si'ko'ku's Bingo Contest

1
First things first...what is your name?* This field is required.
First Name
Last Name
2
Are you 12 years old or older?* This field is required.Note: You must be 12 years or older to enter
YESNO
3
Which community are you from?* This field is required.Please select one of the options below
Please Select
Please Select
Annapolis Valley First Nation
Eskasoni L'nue'kati
Glooscap First Nation
L'sitkuk First Nation
Membertou First Nation
Millbrook First Nation
Paqtnkek Mi'kmaw Nation
Pictou Landing First Nation
Potlotek Mi'kmaw Nation
Sipekne'katik First Nation
Wagmatcook First Nation
Wasoqopa'q First Nation
We'koqma'q L'nue'kati
You must be from one of the 13 Mi'kmaw communities in Nova Scotia
4
If you win, how can we contact you?* This field is required.We will only use this information to contact winners
Please enter your email
Please enter your phone
5
What is your home address?* This field is required.We will only use this information for prize delivery/pick-up, and confirm the number of entries per household
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Photo Permission* This field is required.Before uploading your photos, please select one of the following:
I am 19 years or older, I give permission for my photo and name to be shared if selected
I am under the age of 19, I understand a parent or guardian will need to give permission before my photos can be shared
7
You've selected that you're under the age of 19, please provide parent/guardian contact information
Parent/guardian name
Parent/guardian phone number
Parent/guardian email address
8
Upload your photo(s)* This field is required.You can upload multiple photos
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
9
Tell us about your photos!Identify photos by bingo number, 1 line or four corners to enter
Huge
Large
Normal
Small
Ok
Ok
10
If you win, which prize would you choose?* This field is required.**Please note the following requirements for Activate: The minimum age to participate in Activate is 6 years old. An adult must be present at the facility throughout the entire gaming experience for children between 6 and 13 years old. Activate requires participants (18+) or a parent/guardian to complete a waiver before play.
Movie at Cineplex🍿(up to 4 people)
Bowling Night at Lanes Membertou 🎳 (up to 4 people)
75 Minute Activate Experience 🏃🏼‍➡️(up to 4 people)
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