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Get Delaware Park Casino Form

Nformation. ACKNOWLEDGEMENT I am voluntarily requesting exclusion from all gaming activities at all Delaware licensed video lottery agents because I am a problem gambler. I certify that the information that I have provided above is true and accurate. I have read, understand and agree to the waiver and release included with this request for self-exclusion. I am aware that my signature below authorizes the Delaware State Lottery to direct all Delaware video lottery agents to restrict my gaming act.

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