GCH Tournament Prize Request

Your first name*

Your last name*

Your e-mail*

Your street and house number*

Your postal code*

Your city*

Your country*

Your birthday*

Your tournament*

Your prize money in €*

Your GCH-code*

Your payout option*
---PayPalBank Transfer

Your payout details*
- If you chose PayPal, please confirm your e-mail from above.
- If you chose Bank Transfer, please enter your account holder name, IBAN and BIC/SWIFT.

Your currency option*
---EUR (default)USD (currency exchange costs may apply)GBP (currency exchange costs may apply)

Here you can tip us in €. This is fully optional but we would appreciate your support.

I confirm that the above data is correct to the best of my knowledge. I understand that this information will be used for the purposes of recording payments related to prize money. I agree that any costs caused by payouts and/or currency exchanges to my PayPal or bank account will be deducted from my prize money.*

I agree to the terms and conditions as described here: https://gorillaclubhouse.com/terms-and-conditions*

Please note that all fields marked with an asterisk (*) are required.