Complete this form to claim your prize!
Are you already registered?
First Name:
*
Last Name:
*
Address:
*
City:
*
State:
*
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode:
*
Phone:
*
Email:
*
Name of retailer where you
purchased your Mitavite:
*
How many horses are you
responsible for:
*
Enter your prize token code:
*
Enter captcha code:
*
I agree to the Mitavite Grand Prize Giveaway
terms and conditions
Terms & Conditions: Open to Aust. residents 18+. All prize claims must be received by 5pm AEDST 28/1/13. Must retain original receipt(s)/invoice(s).
(Download)