Get the free Self-Exclusion Request Form

This form is to be completed by a patron requesting to be excluded from gaming activities at Tioga Downs Casino. All information contained on this form is confidential.

How to fill out self-exclusion request form

How to fill out Self-Exclusion Request Form

1. Obtain the Self-Exclusion Request Form from the relevant gambling authority or website.
2. Fill in your personal details including name, address, and date of birth.
3. Indicate the duration of your self-exclusion (e.g., 6 months, 1 year, etc.).
4. Select which types of gambling activities you want to be excluded from (e.g., online betting, casinos, etc.).
5. Provide any additional information required, such as your gambling habits or reasons for exclusion.
6. Review your information to ensure accuracy.
7. Sign and date the form to confirm your request.
8. Submit the form to the designated authority, either in person, by mail, or electronically if available.

Who needs Self-Exclusion Request Form?

1. Individuals who want to take a break from gambling.
2. People who feel that their gambling behavior is becoming problematic.
3. Gamblers seeking to prevent themselves from engaging in gambling activities.
4. Anyone who has noticed negative impacts of gambling on their personal life or finances.

People Also Ask about

Is self-exclusion permanent?

Minimum self-exclusion periods are one year, five years or lifetime.

What is a self-exclusion request?

Self-Exclusion is a process that allows a person to request to be banned from all legalized gaming activities and to be prohibited from collecting any winnings, recovering any losses or accepting complimentary gifts or services or any other thing of value from a licensee.

What is the self-exclusion period?

The self-exclusion counselling sessions are free. An person that is excluded from gambling activities cannot take part in any gambling activity for a period of 6 months while they receive treatment.

What is the maximum amount of time a self-exclusion order will stay in place?

A self-exclusion lasts for a maximum of three years and may not be revoked within the first six months. After it has been in place for six months, it may be revoked through a Gamblers Help counsellor.

How long does self-exclusion last?

Types of self-exclusion You can register for 6 months, 1 year or 5 years.

How to get around self-exclusion?

The best and most effective way of avoiding your self-exclusion restrictions is by joining s not on GamStop. They're not linked to the scheme and offer safe gambling havens for self-excluding Brits.

How to get around self-exclusion?

The best and most effective way of avoiding your self-exclusion restrictions is by joining s not on GamStop. They're not linked to the scheme and offer safe gambling havens for self-excluding Brits.

What is an example of self-exclusion?

Self-exclusion is when you ban yourself from a gambling venue (or part of a venue) or online wagering service for a period. Self-exclusion is an important tool for dealing with gambling harm (in addition to seeking help from a Gambling Help service).

For pdfFiller’s FAQs

What is Self-Exclusion Request Form?

The Self-Exclusion Request Form is a document that individuals can fill out to voluntarily ban themselves from certain gambling activities or establishments.

Who is required to file Self-Exclusion Request Form?

Individuals who wish to limit their gambling activities due to personal issues, such as addiction, are required to file a Self-Exclusion Request Form.

How to fill out Self-Exclusion Request Form?

To fill out the Self-Exclusion Request Form, individuals should provide their personal information, including name, address, date of birth, and other identifying details, and sign the form to indicate their intent to self-exclude.

What is the purpose of Self-Exclusion Request Form?

The purpose of the Self-Exclusion Request Form is to help individuals manage their gambling behaviors by providing a formal mechanism for voluntarily prohibiting themselves from participating in gambling activities.

What information must be reported on Self-Exclusion Request Form?

The Self-Exclusion Request Form typically requires personal information such as full name, address, date of birth, contact information, and may also include additional details regarding the specific gambling activities from which the individual wishes to be excluded.