Self Exclusion from NSW Clubs & Hotels

BetSafe can assist you with self exclusion from up to 10 NSW clubs and hotels in 3 easy steps:

  1. Complete the request for self exclusion form below, making sure all of the information you enter is correct.
  2. Follow the instructions and complete the self exclusion documentation which will be sent to you by registered post.
  3. Return the paperwork to us in the envelope provided along with the documentation.

Your Details

Please enter your full name (as it appears on your photographic identification)
 
Residential address
Postal address (if different to residential address)

Identification

We require a clear copy of a current photographic identification document in order to allow us to verify that the photo which you provide is you. Accepted photographic identification documents are Driver's Licence, Rider's Licence, Proof of Age Card and Passport. If you have a change of address label on the rear of your Licence or Proof of Age Card, please provide a copy of both sides.
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Photo

We require a recent photo (within the past 6 months) of you in order to assist the venue/s to enforce your self exclusion.
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Nominated Venues for Self Exclusion

Please nominate each individual venue which you want self exclusion from on a separate line (limit of 10 venues).

Self Exclusion Period

Terms & Conditions

  1. I understand that BetSafe will send me the documentation required for self exclusion to my residential address (or postal address, if specified) by registered post. I understand that where my personal details have previously been verified by BetSafe, the documentation may be sent by regular post.
  2. I understand that I will not be self excluded from the nominated venues until each venue receives the relevant forms and implements the self exclusion.
  3. I understand that whilst BetSafe will take all steps necessary to notify the nominated venues, BetSafe will take no responsibility for documentation that has been lost in transit or failure to notify the nominated venues.
  4. I understand that the nominated venues may not be under any obligation to accept my request for self exclusion. Whilst BetSafe may take reasonable steps to notify me if a venue is not willing to accept my request for self exclusion, BetSafe makes no undertaking that I will be notified in this event.
  5. I understand that I can contact the nominated venues directly to confirm whether my self exclusion has been processed or to arrange self exclusion if the documentation provided by BetSafe is not accepted.
  6. I understand that the nominated venues may send a letter to me confirming receipt of my request for self exclusion.
  7. I understand that if I do not follow the instructions provided by BetSafe, or these terms and conditions, that the nominated venues may not be notified of my request for self exclusion.
  8. I understand that each of the nominated venues may have policies, procedures and/or requirements that I must adhere to in order to terminate my self exclusion. I understand that I may remain self excluded from the nominated venues until I satisfy their requirements for terminating my self exclusion.
  9. I fully indemnify BetSafe and will not hold BetSafe liable for anything resulting from them agreeing to process this request for self exclusion.