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Only emailed entries using this form will be accepted. Only one entry per mailing address per month will be accepted, and only one winner per mailing address per year will be allowed. The total value of the Century House menu items selected for your Dinner-For-Two cannot be greater then $75.00 excluding tax and gratuity. This prize has no cash value. Refunds will not be given for any portion of the prize not used. Cannot be combined with any other coupons, discounts or other Century House Restaurant offers.