Personal Data Verification STEP 1/2

First and Last Name

Date of Birth

Postal Code

City

Province

Street address

Citizenship

Country of residence

Mobile Phone Number

Employment Info

Employer

Employer Address

Business Phone Number

Industry

Occupation

(REQUIRED) I am a PEP, HIO or a Family Member or close associate of a PEPFP, PEDP or a HIO.

(REQUIRED) I agree to the Terms of Service, confirm I am 19+ years old, my registration information is accurate, and I’m prohibited from allowing anyone else to access my account. I am not a casino key employee in NJ prohibited from wagering in any casino or simulcasting facility.

Back to step 1

Back to Step 1