Credit Application Circa Resort & Casino


*  Indicates field is required
Personal Information

Personal Information





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* **


ft in
lbs
cm
kg
** You must provide a Passport or Driver's License
** International Applicants must provide a Passport or International ID
Trip Information

Trip Information

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Employment Information

Employment Information

$

New Jersey Gaming Declaration

Are you a gaming related casino employee, a state officer or employee, member of judiciary or legislature, or an officer of a municipality or county in New Jersey?


Financial Information

Financial Information
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$
$
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Primary Bank Information

Account #1

Pre-paid debit and credit cards are not valid options.
 * Applicant must be the sole proprietor of this account
Secondary Bank Information

Account #2

Pre-paid debit and credit cards are not valid options.
 * Applicant must be the sole proprietor of this account


Gaming Information Other Casino Credit

Gaming Information Other Casino Credit





Sign Here

LINE OF CREDIT DISCLOSURES AND TERMS & CONDITIONS

I, the undersigned, have applied for a line of credit with Circa Hospitality Group III LLC, doing business as Circa Resort & Casino ("Circa Resort & Casino"). In relation to that line of credit, I authorize Circa Resort & Casino to obtain and verify my financial information (including but not limited to account balance information and credit score) from any source, obtain my financial and employment history in accordance with the provisions of the Fair Credit Reporting Act, and exchange information with others about my financial and account experience with Circa Resort & Casino. I agree not to hold Circa Resort & Casino responsible or liable for the information released or for its use of any such information. I agree Circa Resort & Casino may retain and use the information on this application and any information it receives, whether or not it approved the credit line, for itself or for its affiliated gaming licensees, the D Las Vegas and Golden Gate Hotel & Casino. I further agree that any line of credit granted to me by Circa Resort & Casino is for gaming purposes only and for use solely at Circa Resort & Casino.

As a condition of being issued a credit line, I understand I will be granted marker‐signing privileges, and I agree to sign credit instruments, also known as markers or checks ("Markers") in the amount of the funds issued to me. Further, I authorize Circa Resort & Casino to complete any of the following missing items on those Markers: (a) the name of payee; (b) a date; (c) name, account number and/or address of any of my banks and financial institutions; (d) electronic encoding of the listed items; and (e) as otherwise authorized by the law; the information inserted may be for any account from which I now or may in the future have the right to withdraw funds, regardless of whether that account now exists, and whether I provided the information on the account to Circa Resort & Casino. Each Marker I sign is a separate transaction. If I receive funds before I execute a Marker, I will promptly sign a Marker, when presented to me, in the amount of funds received.

I hereby authorize Circa Resort & Casino, in its sole discretion, to apply any and all chips, sports book, keno or slot winnings, or other prize, cash, or cash equivalents that I may have earned, redeemed, or received while at Circa Resort & Casino or that I may have on deposit as front money at Circa Resort & Casino, first to the reduction of any outstanding credit balance, and the remainder, if any, to be returned to me.

I acknowledge that irrespective of any currency exchange laws in the country in which I reside, I have the ability and intent to legally pay through my bank or financial institution the funds represented by the Markers issued by Circa Resort & Casino and signed by me.

I agree that the line of credit and the Markers will be governed, construed, and interpreted pursuant to the laws in the State of Nevada and venue shall lie solely and exclusively in that state. I agree that Circa Resort & Casino may litigate any dispute involving the credit line, the debt, the Markers, or the payee in any court, state or federal, in Nevada. I submit to the jurisdiction of any court, state or federal, in the State of Nevada. I agree to pay all costs of collection of the credit line, the Markers, and/or the debt, including attorney’s fees, costs, and interest at the highest statutory amount permitted by Nevada law, in addition to any other amounts authorized by law. I waive any requirement of presentment and I waive any objection I may have to jurisdiction in such court. I further understand that any judgment Circa Resort & Casino receives in its favor regarding my line of credit, Markers, and/or outstanding debt, can be enforced against me or my estate for collection in my home state, province, or country, or in any jurisdiction in which I have assets, as applicable laws permit.

I understand that the application and these Disclosures and Terms & Conditions are required by the regulations of the Nevada Gaming Commission, and that Circa Resort & Casino and its affiliated gaming licensees are subject to various state, federal and local laws. I agree to assist Circa Resort & Casino in complying with its obligations under such laws. I further understand that I am subject to civil and criminal liability if any material information provided by me is willfully false.

Circa Resort & Casino endorses responsible gaming. At your request, we will provide you with information on our self‐limiting program. We will also cancel or limit your access to marker signing privileges at your written request. If you or anyone you know may have a problem gaming responsibly, please call the 24‐hour Problem Gambler’s Helpline at 1‐800‐522‐4700.

Warning: For the purpose of Nevada law, a credit instrument is identical to a check and may be deposited in or presented for payment to a bank or other financial institution on which the credit instrument is drawn. Willfully drawing or passing a credit instrument with the intent to defraud, including knowing that there are insufficient funds in an account upon which it may be drawn, is a crime in the State of Nevada which may result in criminal prosecution in addition to civil proceeding to collect the outstanding debt.

Privacy Policy

Click here to view the Privacy Policy for Circa Resort & Casino.

Click here to view the Privacy Policy for NRT Technologies, Inc. and VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Circa Resort & Casino and its agent NRT Technologies, Inc. and VisuaLimits, LLC. ("NRT") and its affiliates to obtain consumer reports, to contact financial institutions, and to check my consumer credit, employment, bank and gaming history in order to evaluate my credit application as well as to update and/or review my account to provide services requested by me, as necessary or as required by law. I authorize Circa Resort & Casino, NRT or its affiliates to verify such information through any source and to report any information to another casino, excluding credit report data obtained from a credit agency, and to exchange any information with any of the affiliates of the Company. I hereby release and waive, and agree not to bring at any time in the future, any claims or demands against NRT or its affiliates relating to any credit investigation made pursuant to my authorization and instructions herein, including, without limitation, the collection, processing, and transmission of my information and data.

NRT Technologies, Inc. and VisuaLimits, LLC. ("NRT") promotes responsible gambling. By entering my name in the signature field and clicking the "I Accept" button below, I acknowledge that I have read the NRT Technologies, Inc. and VisuaLimits, LLC. Responsible Gaming Policy.

By entering my name in the signature field and clicking the "I Accept" button below, I hereby represent, warrant, and agree that all information provided herein is true and correct, that I am the person for whom I am requesting credit, and that I have read, understand, and agree to be bound by all of the terms herein.

I hereby acknowledge and agree that this Application may be signed electronically and that such electronic signatures shall be deemed an original for all purposes. I represent and warrant that by signing this Application electronically or causing this Application to be signed electronically that I have the authority to do so and that such electronic signature shall be sufficient to bind the respective party under this Application.


Physical Signature


Sign Here