WEVaxtowin
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 WEVax To Win Entry Form
 Please ensure your first name, last name, and last 4 numerical digits of your health card, match exactly as it appears on your proof of COVID-19 vaccination
*Match exactly as it appears on your proof of COVID-19 vaccination receipt
*Match exactly as it appears on your proof of COVID-19 vaccination receipt
(Last 4 numerical Digits, no dash)
The 4 last numerical digits can also be found on your vaccination receipt
Full 4-digit year required, e.g. 1951
The street address should begin with the house number (i.e 1111 Sample Ave)
Do you own, or rent at this address?
Disclaimer Declaration

I acknowledge that I have been fully vaccinated against COVID-19.

 By clicking “submit” below, you agree that you have read and understand the Contest Rules, and agree to the terms therein. As well, you agree to the collection of your personal information, including but not limited to your name, mailing address, telephone number, e-mail address, year of birth, the last four (4) digits of your health card number and vaccination status, to be used for the purpose of verifying Contest entrants and winners, and further agree that your name will be disclosed if selected to win a prize. If the entrant is under the age of 18 at the time of entering the Contest, you agree that you are the parent or guardian of the entrant, you agree to the Contest Rules on behalf of your dependent child, and you further agree to the collection, use and disclosure of your dependent child’s personal information as outlined above.
 By clicking “submit” below, you agree to release The Corporation of the City of Windsor, The Corporation of the County of Essex, and theirs affiliates, subsidiaries, agencies, agents, Councillors, administrators, employees, representatives, sponsors, successors and assigns from any and all liability for any loss, harm, damages, claims, costs, causes of action or injury whatsoever including, but not limited to personal injury, accident or death, property damage, disappointment or inconvenience arising from any act, omission or negligence whatsoever relating to the Contest or the receipt, ownership, possession or use of any prize.
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