The information you provide below supports this application as well as any future applications for revocation of your Self-Exclusion.

IMPORTANT INFORMATION BEFORE YOU START

  • By completing this request for self-exclusion, you are requesting to self-exclude from all The Star Casinos, or both The Star Casinos and Crown Casinos. This request for self-exclusion will be followed by the issuance of an exclusion order.

  • For The Star Casinos – You will be excluded and prohibited from entering or remaining in The Star Sydney Casino of 80 Pyrmont Street, Pyrmont NSW 2009; The Star Gold Coast Casino of 1 Casino Drive, Broadbeach QLD 4218; and The Star Brisbane Casino of 33 William Street, Brisbane City, QLD 4000 (together, The Star Casinos).

  • If you request to Self-Exclude from both The Star Casinos and Crown Casinos, you will be excluded and prohibited from entering or remaining in the Crown Sydney VIP Casino of 1 Barangaroo Avenue, Sydney NSW 2000; Crown Melbourne Casino of 8 Whiteman Street, Southbank VIC 3006; and Crown Perth Casino of Great Eastern Highway, Burswood WA 6100, (together, Crown Casinos).

  • The Star Sydney Casino is required by law to inform Crown Sydney VIP Casino of your exclusion, even if you only elect to self-exclude from The Star Casinos. Crown Casinos may act to exclude you.

  • Self exclusion orders will be sent by registered mail to the current residential address you provided. 

* Indicates Required Field

Checklist and Consent

I wish to make this self-exclusion application. In making this application, I acknowledge and agree to the following.

View Self Exclusion Terms and Conditions

View Self Exclusion Online Privacy Collection Statement

This includes information on our use of Facial Recognition Technology.

 

 

Part 1 of 5 – Self-Exclusion Request

What type of Self-Exclusion are you choosing?

 

 

Part 2 of 5 – Personal Information

 

 

Part 3 of 5 – Your Play Profile

 

 

Part 4 of 5 – About Your Self-Exclusion

You will be issued with a self-exclusion order which prohibits you from entering and remaining in the casino at The Star Gold Coast and The Star Brisbane pursuant to section 91N of the Casino Control Act 1982 (QLD) and a voluntary exclusion order which prohibits you from entering and remaining in the casino at The Star Sydney pursuant to section 79 of the Casino Control Act 1992 (NSW).

 

 

Part 5 of 5 – Your Self-Exclusion Application

In accordance with the Privacy Collection Statement, I agree to provide the following evidence of my identity in connection with my request for self-exclusion.

To prove that you are the person in the photo ID, applicants must also provide a self-verification photo of themselves holding their photo ID. Ensure the photo ID you are holding is clear and readable, view examples linked below.
View Sample
 
One file only.
200 MB limit.
Allowed types: jpg, png, pdf.
Acceptable forms of ID
 
Maximum 2 files.
200 MB limit.
Allowed types: jpg, png, pdf.
Photo Guidelines
 
One file only.
200 MB limit.
Allowed types: jpg, png, pdf.
I agree to sign, have it witnessed and return the completed documents to The Star Casinos.
Download request for self-exclusion The Star Casinos/Crown Casinos

You are required to download the above form. Complete, sign, have it witnessed and then upload it here.
 
One file only.
200 MB limit.
Allowed types: pdf.