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1. National Mom's Nite Out - Pizza Hut Registration

Thank you for your interest in the Pizza Hut Takin' Care of Dinner Prize Pack program. To register to receive your prize pack including a $25 Pizza Hut Gift Card, please fill in the fields below. If you are selected to participate, we'll be in touch with more details.

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* 1. First and Last Name

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* 2. Street Address

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* 3. City

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* 4. State

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* 5. Zip

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* 6. Email Address

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* 7. Phone Number

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* 8. Blog Name (if applicable)

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* 9. Blog URL (if applicable)

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* 10. Twitter ID (if applicable)

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* 11. What are your plans for National Mom's Nite Out?

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