First Name
Last Name
Address
City
State
Zip Code
Daytime Phone #
Alt Phone #
Email Address
Midland Daily News Issue Date
House Address Where Lou E is hiding
If you are under 18 years of age you must receive your parent’s or legal guardian’s permission to enter this contest. You must present the following information as consent of permission:
Parent/Legal Guardian Name
Parents Phone
Contact Information
Address or E-mail if different from above
Parent or guardian has given permission to enter this contest.
