Self-exclusion

Gambling Commission - Licence Conditions and Code of Practice

If you feel you have a problem with gambling and would like to request that Woking & Sam Beare Hospices excludes you from all of its gambling related activities, including receiving gambling related marketing materials, you can simply complete and submit the form below.

I have a gambling problem and therefore wish to be excluded immediately from all of Woking & Sam Beare Hospices' gambling related activities, including receiving any gambling related marketing materials from Woking & Sam Beare Hospices, for a minimum period of:

I acknowledge that I will not be allowed to rescind my self-exclusion during this period.

Following our successful completion of your self-exclusion request:

Your chosen self-exclusion period will remain in force with Woking & Sam Beare Hospices, for a minimum of 7 years
Woking & Sam Beare Hospices will not send you any gambling related marketing materials, unless and until you specifically request us to do so.

Please ring the Woking & Sam Beare Hospices Lottery helpline on 01483 742857, if you wish to extend your chosen self-exclusion period (minimum 6 months extension).

Personal details

Title*:

First name*:

Last name*:

Date of birth*:

Email address*:

Verify email address*:

Contact number*:

Enter your house number/name and postcode, then click 'Find address'

House number/name:

Enter Postcode and click "Find my address" or click "Enter address manually"

Postcode:

Enter address myself

House number/name*:

Address line 2:

Address line 3:

Address line 4:

Town*:

County:

Post code*:

I acknowledge my responsibility in ensuring adherence to this agreement. I acknowledge that the Promoter, its employees or agents have no liability or claims arising from my voluntary use of the gambling facilities provided.