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$5 each Ticket
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Split the Pot
$5 each Ticket
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Mens Package
For $125 receive 1 ticket in 14 prizes ($270 Value)
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Quick Pay**
For $360 receive one ticket in every box ($815 Value)
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Additional Comments

Only enter this field if you were told to do so by a staff member.

**Excludes Grand Prize, Jackpot, or Split the Pot.

***By participating and accepting the grand prize, the "Winner" is entitled to receive remodeling services from BELFOR, total retail value of $36,000. Prize must be taken as offered. The prize, or any unused portion of the prize, is not transferable, refundable or exchangeable and cannot be redeemed as cash. The prize is available and to be fully completed within one (1) calendar year. BELFOR reserves the right to change the prize to the same or equal value at any time if the prize becomes unavailable. The prize cannot be used in conjunction with any other special offer. Winner is solely responsible for reporting and paying any and all applicable taxes related to the prize(s) and paying any expenses associated with any prize which are not specifically provided for in the official rules. By participating, where allowed by law, all participants and winner(s) grant BELFOR exclusive permission to use their names, characters, photographs, voices, videotape, and likenesses in connection with promotion of this and other contests and waive any claims to royalty, right, or remuneration for such use. By participating, where allowed by law, participants agree that BELFOR may disclose personal information obtained from participants in the Contest to third parties and use such information for marketing and other purposes. Prize is subject to terms and conditions. It is the winner's responsibility to read and understand the terms and conditions of the Prize.
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