Sweepstakes Registration
All players must provide a valid ID and must by 18years or older. Thank you for helping raise funds for the Texas Firewalkers
Name
First Name
Last Name
Birth date
-
Month
-
Day
Year
When were you born
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Desired Account name
Use 13 or less characters with letters, underscore & numbers. NO SPACES ALLOWED
Upload the front side of your Driver's License
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Upload the back side of your Driver's License
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of
Signature need
Submit
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