Contest Form

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First Name *

Last Name *

City *

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Email Address .

Phone # (10 digits) * Winners will be contacted by phone.

Age *

• 21 - 24
• 25 - 35
• 36 - 50
• 51 - 70
• 71+

Marital Status *

• Married
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Household Income *

• $0 - $39,999
• $40,000 - $49,999
• $50,000 - $69,999
• $70,000+

Contest Rules *

• I agree with the contest rules

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Sign Up Today to Win this Season's Big Prizes!!
The Portland Pirates and Steele Hill are bringing you great prizes for the 2012-2013 season. Enter now for your chance to win!!

Grand Prize:

• 7 Nights Luxury accommodations

2nd Runner Up: New England Escape

• 4 Nights at Steele Hill Resorts Located in New Hampshire's Lakes and Mountains region

Special Prize:
Official Autographed Pirates Memorabilia Prize Pack!!

• 2 Official Pirates' Hockey Sticks
• 2 Official Pirates' Jerseys
• 2 Official Pirates' Hats
• 2 Official Pirates' T-Shirts

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