5000

STEP 1 PICK YOUR PLAN

Choose the Draw Plan you wish to subscribe for and the number of boards you wish to play.

STEP 2

PICK YOUR NUMBERS

STEP 3 COMPLETE THE FOLLOWING

Indicate the type of subscription. Please print clearly.

Pick one or up to five sets of six numbers between 1 and 49 without duplicates. To play more than 5 Boards, please complete additional entry forms.

Individual Group Gift Certi cate

GIFT CERTIFICATE WILL BE SENT TO YOU, THE PURCHASER. The gift certificate must be redeemed within 365 days of the date of purchase; otherwise, the subscription will automatically be activated in the name of the purchaser below, who will be the subscriber.

Board 1 or QUICK PICK Board 2 or QUICK PICK Board 3 or QUICK PICK Board 4 or QUICK PICK Board 5 or QUICK PICK

PURCHASER INFORMATION
Mr. Mrs. Ms. Miss First Name (one name only) Last Name Address City
ONTARIO (must be an Ontario resident)

Apt.

Province Date of Birth Phone (Day) Language of Preference (DD) (MM) (Evening) English

Postal Code (YYYY)

Choose QUICK PICK

Check the QUICK PICK box(es) if you would like our computer to select 6 numbers to be played for the duration of your subscription.

Franais

STEP 4

PAYMENT

Cheque

Money Order

VISA

MasterCard

Credit card account number

Amount of Purchase

Expiry Date
I hereby authorize OLG to disclose my personal information to a third-party vendor in order to verify that I meet the statutory age requirements. I have provided complete and accurate information. I have read and understand the Terms and Conditions.

IMPORTANT: OLG will make every effort to enter subscriptions into the system as submitted. If there is a discrepancy, only the numbers and draws recorded in OLGs central computer system participate. Incorrectly completed subscription forms will be returned in their entirety. PLEASE ALLOW 4 TO 6 WEEKS FOR PROCESSING. Complete rules available upon request at olg.ca. Subscriptions available to residents of Ontario only. Subscription is confirmed with an Official LOTTO ADVANCE Certificate. All certificates should be checked for accuracy as they contain the official start date, expiry date and numbers being played for the subscription. OLG is not responsible for errors or omissions. The sale of a subscription to Individuals under the age of 18 is prohibited, and prizes related to such subscriptions cannot be paid. The payee hereby certifies that he/she is 18 years of age or older. Cheques for prizes less than $1,000 will be sent by mail. If the amount is $1,000 or more, winners will be contacted by OLG.
Personal information is collected under the authority of the Ontario Lottery and Gaming Corporation Act, 1999. The information will be used for subscription administration purposes including age verification by OLG or its third-party service provider, marketing and advertising, OLG internal purposes and to comply with legal requirements. By providing your personal information, you consent to OLG disclosing your name, address and birth date to a third-party service provider for age verification purposes and to OLG collecting your personal information from such service providers in order to confirm that you meet age requirements. When photocopies of government-issued identification (e.g. , drivers licence) are submitted to OLG for age verification purposes, this information will be securely destroyed after age verification is completed. Terms and Conditions are available at olg.ca. Any questions may be directed to the OLG Support Centre at 1-800-387-0098.

(Payable to OLG. Please note post-dated cheques cannot be accepted.)

Individual, Gift Giver or Group Captain, please sign

olg.ca