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Self exclusion form

This form is to be used by players and persons wishing to self-exclude themselves from one or more of the lotteries and gambling operated by the society or within the society group of companies.

The person completing this form should read the Self-Exclusion Information Sheet available online.

The player must affirm below that they have read and understood the consequences.

Your details


Telephone numbers

By submitting this form I confirm I have read the self-exclusion information sheet and understood the consequences of self-exclusion.