Customer Service Agreement Ameristar St. Charles

Applying for

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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


Gaming Information Other Casino Credit

Gaming Information Other Casino Credit




Customer Service Agreement

I agree to repay all sums that become due and owing by me to Ameristar Casino St. Charles, Inc., (ACSC) arising out of credit issued and I waive any right, statutory or otherwise, to stop payment on any instruments issued in connection with credit issued to me. I agree to pay a fee of $35 for each check returned unpaid by my bank. I agree to submit to the personal jurisdiction of any court, federal or state, in Missouri should legal action be taken by ACSC to collect any outstanding balances owed by me to ACSC and agree to pay all costs of collections including attorney fees. I hereby waive any defense to any such action based on lack of personal jurisdiction or improper venue. I certify that I have reviewed all of the information provided above and that it is true and accurate. I authorize ACSC and its affiliates, directly or through its vendors, to conduct such investigations related to the above information as deemed necessary for the approval of my application for credit. I am aware that this application is required to be prepared in accordance with the internal controls for ACSC as may be applicable as approved by the Missouri Gaming Commission and I may be subject to civil or criminal liability if any material information provided by me is willfully false. I hereby authorize ACSC within its sole discretion, to apply any and all monies otherwise payable to me including gaming instrumentalities such as TITO tickets I may redeem first to the reduction of any outstanding credit balance, with the remainder, if any, to be paid to me.

Privacy Policy

Names and other personally identifiable information, whether public or non-public, may be released to affiliated (by contract, equity or otherwise) persons and/or entities of Ameristar Casino St. Charles, Inc. (including, without limitation, strategic alliances, advertising, casino, resort, hotel and restaurant affiliated persons and/or entities, (ACSC or We). We may share your personal information with consumer reporting agencies, our affiliates or with select third parties who offer goods or services We think may be of interest to you. We also may share information in order to comply with applicable law, investigations or judicial processes. From time to time, We may contract with other organizations or companies to provide co-sponsored or co-branded promotions, services or events and may share your personal information with such entities. Additionally, We may provide your personal information to service providers or contractors to perform functions on our behalf, such as, but not limited to companies or individuals hired to: communicate news, deliver our promotional materials via email and direct mail, promote our and our affiliates' social media presence and activities, to develop, enhance, market or provide any of ACSC and its affiliates products, to process credit card payments and to assist ACSC and its affiliates with sending communications and performing other market and support functions. Also, ACSC and its affiliates may use third-party social media platforms, including third-party social media websites, to communicate with you.



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

Signature

I, the undersigned, hereby authorize ACSC, its affiliates, and its vendors, including NRT Technologies, Inc. and VisuaLimits, LLC and its affiliates ("NRT") 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 ACSC, its affiliates and its vendors, including NRT and its affiliates to verify such information through any source. Further, I authorize NRT and its affiliates to report any information to other casinos unrelated to ACSC and its affiliates, excluding credit report data obtained from a credit agency, and to exchange any information collected with other parties unrelated to ACSC. I hereby release and waive, and agree not to bring at any time in the future, any claims or demands against ACSC, its affiliates and its vendors including NRT and its affiliates relating to any credit investigation made pursuant to my authorization 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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