Credit Application Blue Chip Casino Hotel Spa


*  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 cards, credit cards, savings, LOC, and HELOC accounts are not valid options.
 * Applicant must be the sole proprietor of this account
Secondary Bank Information

Account #2

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


Gaming Information Other Casino Credit

Gaming Information Other Casino Credit





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License Agreement

I certify that I have reviewed all information provided and that it is true and accurate. I authorize Blue Chip Casino or its agent to conduct such investigations pertaining to the above information as it deems necessary for the (Blue Chip) approval of my credit limit. I understand that any and all checks signed by me pertaining to this transaction may be micro-encoded, deposited, and charged directly against the bank account designated above. I further understand that knowingly providing false, inaccurate, or misleading information on this Credit/Check Cashing Application may subject me to criminal and/or civil liability. In the event legal action is brought by Blue Chip against me to collect any amounts owed by me to Blue Chip, I further agree: 1) to submit to the jurisdiction of any state or federal court located in Indiana; 2) that said action shall be governed by the laws of the State of Indiana; 3) to pay interest on all amounts owed at a rate equal to the lesser of 18% per annum or the maximum rate allowed by the law; and 4) to pay all of Blue Chip’s costs and disbursements, including reasonable attorney fees, incurred by Blue Chip in connection with the collection of any amount loaned by Blue Chip to me.

I hereby authorize Blue Chip Casino to investigate my credit record and to furnish information concerning such credit record to credit reporting agencies and other who may properly receive this information.

Privacy Policy

Click here to view the Blue Chip Casino Privacy Policy.

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

Signature

I, the undersigned, hereby authorize and instruct Blue Chip Casino Hotel Spa 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 Blue Chip Casino Hotel Spa, 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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