Credit Application Belterra Park


*  Indicates field is required
Personal Information

Personal Information






ft in
lbs
cm
kg

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

Bank Account #1

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

Bank 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




License Agreement

I agree to repay all sums that become due and owing by me to PNK (OHIO), LLC, 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 submit to the personal jurisdiction of any court, federal or state, in Ohio should legal action be taken to collect any outstanding balances owed by me and agree to pay all cost 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 PNK (OHIO), LLC, 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 PNK (OHIO), LLC's internal controls as approved by the Ohio Lottery Commission and I may be subject to civil or criminal liability if any material information provided by me is willfully false. I hereby authorize PNK (OHIO), LLC within its sole discretion, to apply any and all monies, and 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 Statement: 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 PNK (OHIO), LLC (including, without limitation, strategic alliances, advertising, casino, resort, hotel and restaurant affiliated persons and/or entities), (PNK (OHIO), LLC 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 process. 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, PNK (OHIO), LLC may provide your personal information to service providers or contractors to perform functions on its behalf, such as, but not limited to, companies or individuals hired to: communicate news, deliver its promotional materials via e-mail and direct mail, promote its and its affiliate's social media presence and activities, to develop, enhance, market or provide any of PNK (OHIO), LLCs and its affiliates products, to process credit card payments and to assist PNK (OHIO), LLC and its affiliates with sending communications and performing other marketing and support functions. Also, PNK (OHIO), LLC and its affiliates may use third-party social media platforms, including third-party social media websites, to communicate with you. Everything I have stated in this application is correct to the best of my knowledge. I understand PNK (OHIO), LLC will retain this application whether or not it is approved. PNK (OHIO), LLC is authorized to check my credit and employment history and to answer questions about your credit experience with me.

Privacy Policy

Click here to view the Privacy Policy for Belterra Park.

Click here to view the Privacy Policy for VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Belterra Park and its agent VisuaLimits, LLC ("VL") 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 Belterra Park, VL 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 VL 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.

VisuaLimits, LLC ("VL") 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 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.