Robitussin "Dr. Mom" Cruise Sweepstakes

*First Name
*Last Name
*Address 1
Address 2
*City
*State
*Zip Code	-
*Email
*Date of Birth	/ /
*Gender

Who lives in your household (not including yourself)?
	Year of Birth		Year of Birth
Adult 2		Child 1
Adult 3		Child 2
Adult 4		Child 3
Adult 5		Child 4
Adult 6		Child 5

Yes, I would like to receive additional information or promotions from Robitussin®.

Yes, I would like to receive additional information or promotions from other Wyeth Consumer Healthcare brands such as Advil® and Centrum®.

* Fields with asterisks are required for sweepstakes entry. See PRIVACY POLICY.

Sweepstakes begins 10/01/03 and ends on 11/30/03 and is open to legal residents of the Continental U.S. who are 18 years of age or older. See OFFICIAL RULES.