Credit Application Hollywood Casino at Charles Town


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Personal Information

Personal Information





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* **


ft in
lbs
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** You must provide a Passport or Driver's License
** International Applicants must provide a Passport or International ID
Trip Information

Trip Information

$

Employment Information

Employment Information

$

New Jersey Gaming Declaration

Are you a gaming related casino employee, a state officer or employee, member of judiciary or legislature, or an officer of a municipality or county in New Jersey?


Financial Information

Financial Information
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$
$
$
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Primary Bank Information

Account #1

Pre-paid debit and credit cards are not valid options.
 * Applicant must be the sole proprietor of this account
Secondary Bank Information

Account #2

Pre-paid debit and credit cards are not valid options.
 * Applicant must be the sole proprietor of this account

Instant Bank Account VerificationSpeeds up approval!

  • This is safe, secure, encrypted, and fast
  • You will need: bank login and bank account information
  • No bank login information is retained by the casino



Gaming Information Other Casino Credit

Gaming Information Other Casino Credit





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License Agreement

*Income from alimony, child support or separate maintenance payments need not be revealed if you do not wish to have it considered as a basis for repayment of the requested credit.

I have completed this application for casino credit and agree that this credit line will be used solely for gaming purposes at Hollywood Casino at Charles Town Races ("Hollywood Casino"). I certify that I have reviewed all of the information provided above and that it is true and accurate. I will advise Hollywood Casino if any of this information changes. I understand that this application is required to be completed by regulations of the West Virginia Lottery Commission and that I may be subject to civil and criminal liability if any information provided by me is willfully false.

I authorize Hollywood Casino to conduct such investigations to verify the information provided and to obtain such credit information relating to me that it considers necessary to approve and thereafter maintain this credit line. I understand and agree that Hollywood Casino may disclose credit information concerning my credit record to credit reporting agencies and others.

I understand that I am responsible for the repayment of credit extended to me. The instruments issued as a result of this credit line and intended solely to provide an additional remedy to Hollywood Casino, and the obligations evidenced by such instruments are governed by the laws of the state of West Virginia. I waive any right, statutory or otherwise, to stop payment on any instrument issued in connection to any credit extended to me. Hollywood Casino may, in its discretion, litigate any dispute arising out of this credit line before any Court having jurisdiction over me. I consent to the jurisdiction of any court, federal or state, in West Virginia. I waive any defense bases on lack of personal jurisdiction or improper venue. Should legal action be taken to collect an outstanding balance, I agree to pay all costs of collection, including reasonable attorneys' fees.

I hereby expressly authorize Hollywood Casino to apply any and all gaming chips I may redeem, first to the payment/reduction of any outstanding credit balance, with the excess, if any, to be returned to me.

Privacy Policy

Click here to view the Privacy Policy for Hollywood Casino at Charles Town.

Click here to view the Privacy Policy for NRT Technologies, Inc. and VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Hollywood Casino at Charles Town and its agent NRT Technologies, Inc. and VisuaLimits, LLC. ("NRT") and its affiliates to obtain consumer reports, to contact financial institutions, and to check my consumer credit, employment, bank and gaming history in order to evaluate my credit application as well as to update and/or review my account to provide services requested by me, as necessary or as required by law. I authorize Hollywood Casino at Charles Town, NRT or its affiliates to verify such information through any source and to report any information to another casino, excluding credit report data obtained from a credit agency, and to exchange any information with any of the affiliates of the Company. I hereby release and waive, and agree not to bring at any time in the future, any claims or demands against NRT or its affiliates relating to any credit investigation made pursuant to my authorization and instructions herein, including, without limitation, the collection, processing, and transmission of my information and data.

NRT Technologies, Inc. and VisuaLimits, LLC. ("NRT") promotes responsible gambling. By entering my name in the signature field and clicking the "I Accept" button below, I acknowledge that I have read the NRT Technologies, Inc. and VisuaLimits, LLC. Responsible Gaming Policy.

By entering my name in the signature field and clicking the "I Accept" button below, I hereby represent, warrant, and agree that all information provided herein is true and correct, that I am the person for whom I am requesting credit, and that I have read, understand, and agree to be bound by all of the terms herein.

I hereby acknowledge and agree that this Application may be signed electronically and that such electronic signatures shall be deemed an original for all purposes. I represent and warrant that by signing this Application electronically or causing this Application to be signed electronically that I have the authority to do so and that such electronic signature shall be sufficient to bind the respective party under this Application.


Physical Signature


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