Request Self-Exclusion Online

* 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.

I Accept Self-Exclusion Terms and Conditions

View Self Exclusion Terms and Conditions

I Accept Privacy Collection Statement

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?

I want to exclude from The Star Casinos

I want to exclude from The Star Casinos and Crown Casinos

Part 2 of 5 – Personal Information

Family name

Given name(s)

Date of birth

Current residential address

Postcode

State

Mobile Number

Email Address

The Star Program Account Number (If applicable)

Part 3 of 5 – Your Play Profile

At which of The Star Casinos do you normally play?

What games do you normally play (Optional)?

How many hours do you usually play per week and how many days a week do you attend (Optional)?

Part 4 of 5 – About Your Self-Exclusion

I am requesting to be self-excluded for the following reasons:

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).

Yes, I understand

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.

ID Self-Verification Photo

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.

Copy of Photo ID

Acceptable forms of ID

Maximum 2 files.
200 MB limit.
Allowed types: jpg, png, pdf.

Recent High-resolution Headshot Photograph

Photo Guidelines

One file only.
200 MB limit.
Allowed types: jpg, png, pdf.

Signed Request for Self-Exclusion The Star Casinos/Crown Casinos

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.