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Registration
 
Register for our contest by filling out the form below. Registration is required for voting.
 
General Information
 
* First Name: 
 
* Last Name: 
 
* Birthday: 
   
 
* Gender: 
 Male      Female
 
* Public Name: 
 
  Must be 4-10 characters
 
* Email: 
 
  Only one registration is allowed per email address.
 
* Confirm Email: 
 
* Phone: 
 
  Will only be used to contact winners.
 
* Address Line 1: 
 
* City: 
 
* State: 
 
* Postal Code: 
 
Password Information
 
Passwords must be 8 to 20 characters.
 
* Password: 
 
* Confirm Password: 
 
Like on Facebook
 
"Like" the pages below to continue.
 
* Enter Text: 
 
Double check to make sure your information is correct and then hit submit below. Thank you for your participation.
By submitting the form you are confirming you are at least 13 years of age and have read and agree to our terms of service and privacy policy.
 
 
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Dairy Queen Lobo Basketball Ticket Giveaway

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