Win/Loss Statement
Join the Club

Please print and complete this form in its entirety. Guests may enter only the last four digits of their social security number if so desired. Please mail or fax(410-629-6678) the form as per the directions below.

Click here to print Win Loss Form
and mail to
Ocean Downs Casino
Player Rewards Club
10218 Racetrack Road
Berlin, MD 21811

Click here to print W2G Form

Player's Club Member Information
(         ) ______________________________
  Players Club Account #  _____________________________________
Please release information concerning my slot activity for the period ending _____/_____/_____

I request that Ocean Downs Casino provide my gaming activity for the time period as indicated. I understand that Ocean Downs Casino makes no representation of warranty, express or implied, as to the accuracy of this information or its effectiveness as proof of losses nor is it intended to take the place of my own records of gaming activity. In consideration of providing this information, I release Ocean Downs Casino and affiliated companies from any and all claims arising from or relating to the information and its release, and further agree to indemnify and hold those entities and persons harmless from any such claim.

Signature ______________________________________ Date _______________________

Check One:               Mail______________________               Pick-Up__________________


Player's Account  ________________________________ Last Name ___________________________
ID Number ________________________________ State Issued ___________________________
Verified By ________________________________ Badge ___________________________
Date Picked Up _________/____________/__________ Date Mailed ________/__________/________
Date Win/Loss Printed ________________________________ Date Filed ________/__________/________

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