Welcome       Winners   
 
Registration
 
Register for our contest by filling out the form below. Registration is required for voting.
 
General Information
 
* First Name: 
 
* Last Name: 
 
* Birthday: 
   
 
* Gender: 
 Male      Female
 
* Public Name: 
 
  Must be 4-10 characters
 
* Email: 
 
  Only one registration is allowed per email address.
 
* Confirm Email: 
 
* Phone: 
 
  Will only be used to contact winners.
 
* Address Line 1: 
 
Address Line 2: 
 
* City: 
 
* State: 
 
* Postal Code: 
 
Password Information
 
Passwords must be 8 to 20 characters.
 
* Password: 
 
* Confirm Password: 
 
Mobile Notifications
 
Enter your mobile phone information to receive occasional reminders and alerts from Palm Springs Lifes' Top of the Town
 
Mobile Phone: 
 
  Enter:  XXX-XXX-XXXX
 
Email Options
 
  
    I would like to recieve updates and special offers from Palm Springs Life Magazine
 
Code Verification
 
Please type the following code in the box below it. The field is not case sensitive.
 
* Enter Text: 
 
Double check to make sure your information is correct and then hit submit below. Thank you for your participation.
By submitting the form you are confirming you are at least 21 years of age and have read and agree to our terms of service and privacy policy.
 
 
   Official Rules      Feedback   

90 DAYS OF SUMMER PALM SPRINGS ROMANTIC GETAWAY

    Powered by © UPICKEM    All rights reserved.