Please complete this form to provide us with your name, e-mail address and customer number. We will use this information to contact the winner of the competition. KBC Bank aims to process your personal data in a manner that is lawful, appropriate and transparent. More information on how we process and share your personal data can be found in our data protection statement. It also explains your rights and how you can exercise them. Our data protection statement, which is updated on a regular basis, is available at www.kbc.be/en/privacy, at your KBC branch or from your intermediary.