Pre-Approval Form Wind Creek Bethlehem

Informational Questions

Please answer the following questions before completing and submitting the application

*  Indicates field is required
Personal Information

Personal Information





* **


ft in
lbs
cm
kg
** 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
$
$
$
$
$
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

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Gaming Information Other Casino Credit

Gaming Information Other Casino Credit





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License Agreement

I hereby certify that the information provided above is true and complete. I authorize Wind Creek Bethlehem, LLC or its affiliates, (collectively, the "Company"), to verify such information through any source, to obtain any credit related, bank related, gaming related, criminal related or employment related history or information about me ("Information"), to report any Information to another casino or a credit reporting agency and to exchange any Information with any of the affiliates part of the Company. I acknowledge receipt of a copy of the privacy policy of the company.

I certify that I have read and understand this application and it’s terms and I execute this instrument voluntarily and with full knowledge of its significance. I authorize Wind Creek Bethlehem, LLC to conduct any investigation necessary for the approval of my credit limit. I am aware that this application is required by the regulations of the Pennsylvania Gaming Control Board. I understand that a Counter Check issued by Wind Creek Bethlehem, LLC is identical to a personal check and may be deposited in or presented for payment to my bank or other financial institution. I acknowledge that willfully drawing or passing a credit instrument with the intent to defraud, including knowing there are insufficient funds in my account is a crime in the Commonwealth of Pennsylvania that may result in criminal prosecution. I am also aware that providing false or misleading statements or omitting information on this application may subject me to civil or criminal penalties. No violation of the Credit Application or any regulation by Wind Creek shall constitute (a) a defense in any action by Wind Creek or a person acting on behalf of Wind Creek to enforce an instrument or the debt that the instrument represents or (b) a basis for a valid counterclaim to such an action or a claim in any action. Further, this Credit Application is not an "other agreement" within the meaning of 13 PA. Stat §3117 that would modify, supplement or nullify any instrument.

Privacy Policy

Click here to view the Privacy Policy for Wind Creek Bethlehem.

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

Signature

I, the undersigned, hereby authorize and instruct Wind Creek Bethlehem 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 pre-approval form 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 Wind Creek Bethlehem, 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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