|
Personal
Information |
| *
Title: |
|
| * First
Name : |
|
| *
Last Name : |
|
| *
Address : |
|
| |
|
| * City
: |
|
| State
: |
|
| Zip
Code : |
|
| *
Country : |
|
| *
Phone 1: |
|
| Phone
2: |
|
| Fax
: |
|
| *
E-mail : |
|
| *
Currency Preference : |
|
| How
did you find us ? |
|
|
Account
Information |
| * Challenge
Question : |
|
| * Challenge
Answer : |
|
| *Internet Password
: |
|
| *Confirm Internet Password
: |
|
*All
New Account Promotions are for first time clients
only,
in case of account duplicity all promotions
will be considered void.
By hitting the " Submit" button
below you are agreeing to our terms
& conditions.
| 1.
Limit of one FREE Bonus per
name/household (new customers
only). 2. We reserve
the right to disqualify the
Bonus wager if incomplete
or false information is given
in ANY field on the signup
form.
3. Restriction
deposit and bonus amount needs
to be wagered 15 times. Baccarat,
craps, and roulette excluded.
Sometimes bets placed in Football Sports Betting Online are excluded
as well..
4. Must be
18 years or older.
[ * ]
Required. |
-
Your password must be at least eight (8)
characters in length and contain any
combination of numbers (0 to 9) and letters
(a-z, A-Z) but no spaces. Make sure it is
difficult for others to guess! |
| -
Valid phone number characters are 0 to 9
and "-". |
|
