Casino Hotel Rewards Club Enrollment Sheet
Personal Information
First Name
Last Name
Middle Initial
Date of Birth
Gender
Female
Male
Other
Prefer not to say
ID / Driver's License #
SSN (Last 4 digits)
Issued State
Contact Information
Street Address
City
State
ZIP Code
Country
Phone Number
Email Address
Membership Preferences
Would you like to receive promotional offers?
Yes
No
Preferred Language
Signature
Signature
Date