Name: MGL Prize Claim
SKU: 193
Availability: InStock

Are you over the age of 18?*

Yes
No

Have you submitted a Form W9 with Militia Gaming League LLC?*

Yes
No

Which Militia Gaming League Event are you claiming the prize for?*

Which prize are you claiming?*

Where did your team place?*

What In Season Prize did your team win?*

Which Season Award?*

Team Name*

Discord Username*

X Handle*

Gamer Tag*

Your Name*

First Middle Last

Your Email*

Enter Email Confirm Email

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred Way of Payment*

PayPal Email*

Enter Email Confirm Email

Double and Triple check for accuracy, payments will not be resent.

Cash Tag*

Double and Triple check for accuracy, payments will not be resent.

What do you use for Zelle?*

What is your Phone Number for Zelle Payment?*

Double and Triple check for accuracy, payments will not be resent.

What is your Email for Zelle Payment?*

Enter Email Confirm Email

Double and Triple check for accuracy, payments will not be resent.

Payment For Entire Team*

I understand that by filling this form I am accepting payment for my entire team and it is on me to disburse payment to the team as agreed between the team or as instructed by admin.

Government-Issued Photo ID – Front*

Government-Issued Photo ID – Back*

Consent*

I hereby declare that all the information provided above is true to the best of my knowledge.

Consent*

I acknowledge that I must complete and provide a W-9 form, including personal and financial information, to receive payment. A registration link will be sent to the email address provided on this form, and it must be completed accurately and in full. Once all necessary steps are finalized, payment will be issued to the registered payment method within 7-10 business days. Any information found to be false will disqualify me and my team from receiving the prize payment.

Consent*

I acknowledge that any intentional dishonesty on this form may render me noncompliant with the Official Rules and requirements, resulting in the forfeiture of any prizes.