CLICK HERE FOR THE LATEST LIVE WIRE ISSUE


File your claim online

To file your claim online, please fill out the fields below. You will reveice and email confirmation of your claim being received.

This form is only for players who have sent in a claim in the past. For those claiming for the first time they must use the fax/mail copy of the claim form

 
Player Number [your phone#]:  
format [4165551212]
Your Full Name:    
Tournament:    
Division:    
Prize Amount:    
Location:    
Position:    
Address line 1:    
Address line 2:    
City:  
Province:    
Postal Code:     -    
Alternate Phone Number:    
Date Of Birth:  
 
Email Address:    
Your Signature:
[please type in I Agree]