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Gambling Self-Exclusion Form
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Self-Exclusion
Request Self-Exclusion
Important Information About Self-Exclusion
Purpose: This form allows you to voluntarily exclude yourself from gambling activities with operators licensed by us.
Your Rights: You have the right to request self-exclusion at any time to protect your well-being.
Duration: Choose a temporary exclusion (1, 3, 6, or 12 months) or a permanent exclusion.
Process: Your request will be processed within 3-5 business days. You’ll receive a confirmation email.
Confidentiality: Your details will remain private and only shared with licensed operators to enforce the exclusion.
Support: For immediate help, contact our support at email info@egrgl.com.
Note: Self-exclusion is binding once confirmed and cannot be reversed until the selected period ends (for temporary exclusions).
Full Name
Email Address
Phone Number
Date of Birth
Exclusion Type
Select Exclusion Type
Temporary - 1 Month
Temporary - 3 Months
Temporary - 6 Months
Temporary - 12 Months
Permanent
Exclusion Start Date
Reason for Self-Exclusion
Additional Comments (Optional)
I confirm that I want to process this self-exclusion request.
Submit Self-Exclusion Request