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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Phone Number (with area code)

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* 5. Address

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* 6. City

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* 7. State

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* 8. Zip Code

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* 9. Birthdate (XX/XX/XXXX)

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* 10. Opt-In to Epic Wings Promotional Emails

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* 11. Opt-In to Epic Wings Promotional Texts (By providing your mobile number, you agree that Epic Wings may send you periodic SMS messages containing but not limited to important information, updates, deals, and specials.)

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* 12. I have read and agree with the Official Rules

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