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Have you ever used our service before? |
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Who may we thank for referring you? |
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Preferred Casino Hotel |
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*Required Information |
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PLAYER INFORMATION |
| * Name: |
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| * Address: line 1 |
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| * Address: line 2 |
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* City:
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* State/Province:
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* Zip/Postal Code:
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Telephone Number:
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| * E-mail:
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* Birthday: (Month/Day/Year)
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| Gender: |
Male
Female |
| Number of visits to a Casino Resort in the past 12 months: |
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* Where do you play? Please list casinos & cities where you are a rated player:
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| Do you receive complimentary offers? Please tell us from where: |
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I Play Mainly:
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Table Games |
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Slots |
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Live Poker |
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Other (please specify below) |
Tell us more about how you play and what kind of comps you get:
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| General Comments: |
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Click "Send" to Submit Your Information |
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