Prize Draw Entry Form

Your details:
Title:		Address:*
Name:*
Telephone:
Email:*
Confirm email:*
* Required information

Would you be most interested in our
Nursing Home?		Or Apartments?

Please let us know where you heard about the Colina Club?

Help us stop spam emails by typing the word "colina" here:*

Please note, the Colina Club is a retirement village for those aged 55 or over, so only those who are old enough will be able to take up the prize.

Please confirm if you are aged 55 or over:

If not, you can still enter the draw and transfer the prize to someone who is aged over 55, provided you have already confirmed their details here:
Title:		Address:
Name:
Telephone:
Email:
Confirm email:

By submitting this competition entry form you are agreeing that we may keep a record of your details so that, from time to time we can send you information on offers and events at the Colina Club. Please note we will never pass on your details to anyone else. Click here to see the competition terms and conditions.

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