WIN a match day experience in the WorkSafe Lounge

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* 1. Name Details

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* 2. Date of Birth

Date

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* 3. Mobile Number

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* 4. Email Address

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* 5. In 25 words or less, tell us what's your most important reason for coming home safely.

All personal information you provide will be used by the Western Bulldogs Football Club, AFL and on behalf of selected third parties in accordance with our Privacy Policy, this may include for promotional and direct marketing purposes and other disclosures as specified in our Privacy Policy found at westernbulldogs.com.au/privacy. By providing your personal information, you agree to such use.

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