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Indy Style Radio Disney Bieber Giveaway
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Registration
 
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 1: 
 
Address 2: 
 
* City: 
 
* State: 
 
* Postal Code: 
 
  
    Please don't give out my email to any other third parties or send me any email other than those that I may have checked elsewhere on this page.
 
  
    Yes, I'd like to receive breaking news alerts from WISH-TV in my email.
 
  
    Yes, I would like to receive daily news headlines from WISH-TV in my email.
 
  
    Yes, I would like to receive a daily weather forecast from WISH-TV in my email.
 
  
    Yes, I'd like to receive emails from WISH-TV/MyINDY-TV about future contests or special offers.
 
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.
 
 
   Official Rules   

Indy Style Radio Disney Justin Bieber Giveaway

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