Showcase Jackpot Level 1

Showcase Jackpots

Register Winner’s Details

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Register Winner’s Details

Please complete the form below on behalf of the caller.

The caller will need to reference the Jackpot Receipt Voucher. This can be found in the Showcase Winner’s envelope provided to the winner by the venue.

Jackpot Receipt Voucher Example

Showcase Jackpot Level 1 Register

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Validation

Venue

Date of Payment

Time of Payment

Win Code

Prize

Name

Phone

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Contact completing the form

The Winner completing this form.
A Contact Person completing this form on behalf of the Winner.

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Level 1