Credit Application Tiverton Casino Hotel


*  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 hereby certify under oath and affirm that I have reviewed all of the information provided above and that it is true, accurate and complete. I authorize Tiverton Casino to conduct such investigations pertaining to the above information as it deems necessary for the approval of my credit limit. I understand that this verification process will be conducted as part of the credit application process. I am aware that this application is required to be prepared by Rhode Island General Laws 42-61.2-3.2(b) and I may be subject to criminal liability for perjury pursuant to R.I. Gen. Laws 11-33-1 et seq and/ or civil liability if any material information provided by me in this application is false.

Pursuant to R.I. Gen. Laws 42-61.2-3.2(b), Tiverton Casino is authorized to extend interest-free, unsecured credit to patrons of the facility for the sole purpose of those patrons making wagers at table games and/ or video lottery terminals at the facility subject to certain terms and conditions set forth in the law and in rules and regulations reviewed and approved by the Rhode Island Lottery. One of those terms and conditions as set forth in the law and the rules and regulations requires that each applicant for credit must submit a written application to the facility that includes certain specific information. (See R.I. Gen. Laws 42-61.2-3.2(d) and Sec. 3 (a) (1)-(8) of Part 1-3 ("Application for extension of credit") of the rules and regulations.)

R.I. General Law 42-61.2-3.2(j) provides in relevant part that Tiverton Casino, the state of Rhode Island, the division of lotteries, and/ or any employee of Tiverton Casino, shall not be liable in any judicial or administrative proceeding to any player, any individual, or any other party, including players or individuals on the voluntary suspension list, for any harm, monetary or otherwise, that may arise as a result of: (1) Granting or denial of credit to a player; (2) Increasing the credit limit of a player; (3) Allowing a player to exercise his or her right to use credit as otherwise authorized; (4) Failure of Tiverton Casino to increase a credit limit; (5) Failure of Tiverton Casino to restore credit privileges that have been suspended, whether involuntarily or at the request of the patron; or (6) Permitting or prohibiting an individual whose credit privileges have been suspended, whether involuntarily or at the request of the player, to engage in gaming activity in a licensed facility while on the voluntary credit suspension list.

Privacy Policy

Click here to view the Privacy Policy for Tiverton Casino Hotel.

Click here to view the Privacy Policy for VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Tiverton Casino Hotel 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 Tiverton Casino Hotel, 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.