MoeNails Prize Claim Form
This form must be completed in order to receive any prizes won from contests run by MoeNails.
Completion of this form must be done ONLY after the prize has be won. By completing this form you agree to the terms, requirements, and conditions related to claiming the prize as stated below.
DO NOT COMPLETE THIS FORM IF YOU DO NOT AGREE WITH THE FORM CONTENTS, CONDITIONS, REQUIREMENTS, AND TERMS.
*If you have questions, or you are in need of the prize name, and value please contact Morgan Miller prior to completing this form. Email: MoeNails@outlook.com*
Date Prize was Won *
MM
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DD
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YYYY
FULL NAME (first and last): Failure to provide the correct name, or providing a name that will cause the delivery of the prize to fail will result in FORFEIT of the prize! *
Your answer
FULL MAILING ADDRESS (include city, state, and zipcode): Failure to provide a COMPLETE and accurate address will FORFEIT the prize! *
Your answer
Valid Phone Number: *
Your answer
Valid Email Address: *
Your answer
Type of Prize Won: *
Your answer
Prize Value ($ dollar amount): *
Your answer
By checking this box; I agree the information provided in this form is accurate and correct. I have double checked the information prior to checking this box in agreement. I understand that errors in the information submitted could result in the forfeit of any prizes that I may have won. *
Required
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