Contact Information

First Name

Last Name

Date of Birth

Must be 21 by 12/16/2024

Email Address

Address Line 1

Address Line 2

City

State

Phone

Postal Code

Mailing County

Are you a veteran?

YesNo

Kentucky State Law prohibits us from shipping alcohol. Will you be able to pick up the winning item from USA Cares Office or make other arrangements?

YesNo

Terms and Conditions: Must be 21 or older. Only the named person on the winning ticket is allowed to claim the prize. 240 tickets are available for this raffle. Only one winner will be selected for all items included in the raffle. The winner will be notified on the day of the drawing and must claim the prize within 48 hours. Failure to claim the prize will result in forfeiture of the prize back to USA Cares. Employees of USA Cares are not eligible to win. USA Cares EIN# 05-0588761; KY Gaming License No. EXE0002098. USA Cares operates as a 501(c)(3).

Prize cannot be shipped and must be picked up at USA Cares HQ.

I have read and accept the terms and conditions

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How many tickets would you like to purchase?

Dollar Amount

Name on Card

Code

Card Number

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Contact Information