Model Registration Registration Username*Username*Email*Email* First NameFirst NameLast NameLast NameStore Name*Store Name*https://enter.lollipops.co.za/lollipops/[your_store]Address 1*Address 1*Address 2Address 2Country*Country*-Select a location-South AfricaCity/TownCity/TownState/CountyState/CountyPostcode/Zip*Postcode/Zip*IDENTITY NUMBER OR PASSPORT NUMBER*IDENTITY NUMBER OR PASSPORT NUMBER*I consent to and agree with the websites Terms And Conditions*I consent to and agree with the websites Terms And Conditions*I Declare That I am Over The Age Of 18*I Declare That I am Over The Age Of 18*Password*Password*Confirm Password*Confirm Password* * Agree Terms & Conditions