#MakeItOrange Video Submission

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Please fill out the following Entry Form to enter the #MakeItOrange contest:

    Indicates required field
YouTube Video URL     
First Name     
Middle Name     
Last Name     
Street Address     
City     
State     
Zip Code     
Email Address     
Date of Birth (mm/dd/yyy)     
Day Phone Number     
Evening Phone Number     
South Florida Charity of Choice     
Website for South Florida Charity of Choice     
Social Media Handle (specify social media platform - i.e. Twitter)     
Entry Details (800 words or less describing how you #makeitorange)     
I am 18 or older and agree to the Official Rules     

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