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$100 Nike Wrestling Store Credit Drawing
Sweepstakes Entry Data
First Name
Last Name
E-Mail Address
Cell Phone
Home/Work Phone
Date of Birth
Address Line 1
Address Line 2
City
State
Alabama
Alaska
Arizona
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California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
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Pennsylvania
Rhode Island
South Carolina
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Canada
US Territory
Guam
Zip Code
Parent Data
Parent First Name
Parent Last Name
Parent E-Mail Address
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