TLC Player Club Application Form
All of the benefits of TLC Membership are only a couple of minutes away.
Complete the membership application below to join. Membership is free. You must be at least 21 years of age to be eligible for membership.
Player Information
E-Mail Address:
First Name:
Last Name:
Join mailing list?
Yes
No
Title
Mr.
Mrs.
Miss
Ms.
Middle Initial
*Birthday (MM/DD/YY)
*Street Address
*City
*State/Providence
*Zip Code
*Home Phone (555-123-4567)
Work Phone
*Anniversary (MM/DD/YY)
Entertainment Interests
*What games do you play?
Select all that apply.
Hold down the CTRL key to select
as many as you want.
Slots
Blackjack
Roulette
Craps
*What denominations do you play?
Select all that apply.
Hold down the CTRL key to select
as many as you want.
Nickels
Dimes
Quarters
$1.00
$5.00
*What kind of music do you enjoy?
Select all that apply.
Hold down the CTRL key to select
as many as you want.
Country
Jazz
Blues
Pop
Rock & Roll
Rap
*What do you like watching or participating in?
Select all that apply.
Hold down the CTRL key to select
as many as you want.
Slot Tournaments
Fishing
Hunting
Auto Racing
Golf
Football
Other
*Do you want to receive special offers through the mail?
Yes
No
