Delaware Park - Racing - Slots - Golf
Players Rewards
Player rewards

Please print and complete this form in its entirety. Guests may enter only the last four digits of their social security number if so desired. Please mail or fax(302-993-2365) the form as per the directions below.

Print Page and mail to:
Player Rewards Club
777 Delaware Park Blvd.
Wilmington, DE 19804
Player's Club Member Information
 
  
Name 
 _______________________________________________________________________________
                 
Address 
 _______________________________________________________________________________
         
City 
_______________________________________
State 
 __________
Zip
 ____________________  
          
Phone 
(         ) ______________________________
SSN 
 ______________________________________
   
  Players Club Account #  _____________________________________
 
Please release information concerning my slot/track activity for the period ending _____/_____/_____
I request that Delaware Park provide my gaming activity for the time period as indicated. I understand that Delaware Park makes no representation of warranty, express or implied, as to the accuracy of this information or its effectiveness as proof of losses nor is it intended to take the place of my own records of gaming activity. In consideration of providing this information, I release Delaware Park and affiliated companies from any and all claims arising from or relating to the information and its release, and further agree to indemnify and hold those entities and persons harmless from any such claim.
   
Signature ______________________________________ Date _______________________
        
EMPLOYEE USE ONLY

Player's Account  ________________________________ Last Name ___________________________
                    
ID Number ________________________________ State Issued ___________________________
                    
Verified By ________________________________ Badge ___________________________
                         
Date Picked Up _________/____________/__________ Date Mailed ________/__________/________
                         
Date Win/Loss Printed ________________________________ Date Filed ________/__________/________
     
      
Player Rewards Copyright © 2008 Delaware Park Management Company, LLC
Contact Information

The Delaware Council on Gambling Problems offers confidential assistance to gamblers, their families, and to those who are concerned about a friend or colleague. The Council provides literature, support meeting information, treatment information, and 24-hour help. Speakers are available for community groups and for professional training.
HELPLINE 888-850-8888  | www.dcgp.org