Contents of the Application

The application for voluntary self-exclusion shall require provision of, at a minimum, the same content required by 205 CMR 133.03(2) through (4), (7), (10) and (11) and (13). The application for voluntary self-exclusion shall also require provision of, at a minimum, the following content: (Mass. Register #1488, 2/3/2023) 233.03: continued Name, home address, email address, telephone number, date of birth, last four digits of social security number of the applicant, and any other information required by the Commission; (2) An acknowledgment by the applicant that the applicant will not enter the Sports Wagering Area or Sports Wagering Facility, or engage in Sports Wagering, for the duration of the exclusion period and until the completion of the reinstatement session required by 205 CMR 233.04(2) (except as provided by 205 CMR 233.02(1)), and that it is the applicant's responsibility to refrain from doing so; (3) An acknowledgment by the applicant that the applicant shall not collect any winnings or recover any losses resulting from Sports Wagering for the duration of the exclusion period and until completion of the reinstatement session required by 205 CMR 233.04(2); (4) An acknowledgment by the applicant that by placing the applicant's name on the voluntary self-exclusion list, the prohibitions identified in 205 CMR 233.02(1) may apply to all forms of gaming offered by any entities licensed by the Commission, as well as by any affiliates of such entities, whether within Massachusetts or another jurisdiction, and that the Commission may share the list with other domestic or international gaming or Sports Wagering jurisdictions resulting in placement on the lists of such other jurisdictions, and may share such portion of the list with designated agents as may be necessary for the purpose of administering the voluntary self-exclusion program; (5) An acknowledgment by the applicant that if the applicant violates the agreement to refrain from entering the Sports Wagering Area or Sports Wagering Facility, or engage in Sports Wagering, the applicant shall notify the Commission of such violation within 24 hours of the violation; and An acknowledgment by the applicant that once the applicant's name is placed on the self-exclusion list, the applicant may be refused entry or ejected from the gaming establishment, Sports Wagering Area or Sports Wagering Facility, or be prohibited from having the applicant's Sports Wager be accepted.