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Customer Account Form
Name:
Sex:
M
F
Email Address:
(Leave e-mail address blank if you do not have an e-mail address)
Birth Date:
(MM/DD/YYYY)
(Under 18 must have
Parental Consent Form
signed by parent to play)
Street Address:
City, State, Zip:
Home Phone #:
How did you hear about White Tiger Internet Gaming? (Check all that apply)
From a friend
Flyer/Poster
Web site
Newspaper Ad
TV Commercial
Radio Ad
At a LAN Party
Magazine
Store sign
Search Engine
Other:
What types of game do you prefer? (Check all that apply)
Action/Adventure
Strategy
Role-playing
Sports
Racing
Simulation
Science Fiction
Fantasy
MMORPG
Other:
What are your favorite games to play right now?
Additional Comments about White Tiger Internet Gaming:
I would like to be included on the mailing list to receive notification of events, games, and additions/changes to the web site (Clear box if you do not wish e-mail to be sent to you)
Customer Account information will be kept confidential. The information collected is used for internal purposes only and will not be released to third parties. Please see our
privacy policy
for more details on how personal information is used.
Submission of this account form entitles you to a free hour of computer or console rental time at White Tiger Internet Gaming. Print out the form that appears after submitting your information and present it to the cashier to receive your free hour.
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