PLEASE FILL OUT THE FORM BELOW.
A VALID ID and PLAYERS CLUB CARD must be presented with this request.
All information on this form must be completed.
Please allow 7 Business days for processing.
It is my understanding that the Player Win/Loss statement is provided as a courtesy. The data contained in this report may not be an accurate reflection of all my activity as it is prepared from the use of player tracking cards and manually rated
table play activity. This information does not include slot activity during the times in which the card is not inserted in the machine or during periods when the player tracking system is malfunctioning. There may have also been occasions when my player's card was inadvertently left in the machine and play generated by another patron was recorded on my account. I further acknowledge this report should not be relied on for tax reporting purposes. The Grand Lake Casino does not guarantee the accuracy of the win/loss statement. Furthermore, Grand Lake Casino does not hold any liability or guarantees for tax reporting purposes. By signing, I agree that I have read and understood the above statement.
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