Self-Exclusion Application. b. I understand that my Self-Exclusion will stay in force until I apply to revoke it. If I decide to revoke my Self-Exclusion, I agree to apply to revoke only after 12 months from the date of my application for Self-Exclusion. c. I understand that the gambling operator(s) will do its best to Statewide Self-Exclusion Form Oklahoma Association on Problem & Compulsive Gambling Notary Public Verification Mail completed form to: Oklahoma Association on Problem & Compulsive Gambling 501 E. Alameda St. Suite E Norman, OK 73071 casinos. In filling out this form, the problem gambler requests that OAPCG send this form to the tribes or casinos within the State of Oklahoma. OAPCG cannot guarantee that each tribe will accept this Self-Exclusion form. In such case, OAPCG will notify the applicant that they will have to contact that tribe or casino in person. Casino after the executed date submitted on the self-ban form. • I will not seek to hold the Choctaw Nation of Oklahoma or Choctaw Nation Gaming Commission liable in any way should I enter a Choctaw Casino and/or use any of the services or privileges therein despite this exclusion request, and I agree to indemnify the Choctaw Nation of Oklahoma The form must be completed, notarized and submitted with a photo. PLEASE UNDERSTAND THAT ONCE YOU COMPLETE THIS FORM AND SUBMIT IT THE BAN IS NON-REVERSIBLE. We also participate in a State Wide Self Ban program which allows you to ban yourself from gambling at all Oklahoma Casinos that participate in the program. Oklahoma Association for Problem and Compulsive Gambling Tribal Casino State-wide Self Exclusion I. OAPCG recognizes the need for some persons to request self exclusion from multiple tribal casinos. In filling out this form, the problem gambler requests that OAPCG send this form to the tribes or casinos within the State of Oklahoma. An estimated 11,000 compulsive gamblers are banned from casinos and gaming centers throughout the state as part of a strategy to curb addictive gambling among Oklahomans, officials said. Today, 15 out of the 23 states with commercial casino gaming operate such programs, and many casino companies run their own voluntary exclusion programs, according to the American Gaming Oklahoma Self Exclusion List. Fill out, securely sign, print or email your tribal casino self exclusion form instantly with SignNow. The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. Available for PC, iOS and Android. Start a free trial now to save yourself time and money! Just ask anyone at the casino whether they maintain their own self-exclusion list. You can also visit the casino’s website (if it has one), but my own research found few that mentioned self-exclusion, although many had links and toll-free numbers to various responsible gambling organizations.
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