Hollywood Curling Cruise Raffle Order Form
Please fill out this form to order your raffle tickets. All information will be kept private, and will be used to contact you to process payment.

Email address *
Raffle Details:
Grand Prize:
An 8 day cruise for two on board Viking River Cruises anywhere they sail in 2018-19

8 day cruise with river-view veranda stateroom
All port charges & free wifi
All meals
Complimentary wine, beer, soft drinks with onboard dinner and lunch service

Tickets are $20. Help us build dedicated ice in California!

First Name *
Your answer
Last Name *
Your answer
Phone Number *
Please put a phone number where you can be reached in case you win the prize.
Your answer
Email address *
Your answer
Address 1 *
Your answer
Address 2
Your answer
City *
Your answer
State/ Province *
Your answer
Zip/ Postal Code *
Your answer
Country *
Your answer
Number of Raffle Tickets *
Tickets are $20 USD each
Payment Option *
Checks may be made out to Hollywood Curling and mailed to PO Box 7872 Van Nuys, CA 91409. *Due to gambling restrictions, we cannot take any online payment for raffle tickets.
When may we contact you?
If choosing to pay by credit card, let us know when we can call you! Please indicate time of day, and what time zone you are in!
Your answer
Name of member who referred you?
Did one of our members refer you? Help them get credit for the ticket sale!
Your answer
I agree to the Terms and Conditions of the raffle *
I would like to receive occasional emails & newsletters from Hollywood Curling.
We will never share or sell your email address.
I would like to add a tax deductible donation
Please add the following amount to my ticket order. Hollywood Curling is a 501-(c)-3 charitable organization, Tax ID Number 26-2477682.
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