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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: 
 
  
    I consent to the station contacting me by phone or email as part of this contest.
 
Password Information
 
Passwords must be 8 to 20 characters.
 
* Password: 
 
* Confirm Password: 
 
Code Verification
 
Please type the following code in the box below it. The field is not case sensitive.
 
* 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 %18% years of age and have read and agree to our terms of service and privacy policy.
 
 
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