1. A. An individual may be placed on the department's self-exclusion list by submitting a request in the form and manner required by this section.
2. B. An individual requesting placement on the self-exclusion list shall submit a completed request for self-exclusion over the internet or as otherwise required by this chapter. If an individual requests to be placed on the self-exclusion for life list, such request shall be made in person at department headquarters or any other location specified by the department.
3. C. An individual requesting placement on the self-exclusion for life list shall submit, in person, a completed request for self-exclusion as required by this chapter. The request shall be delivered to department headquarters or any other location specified by the department.

4. D. A request for self-exclusion shall be in a form prescribed by the department that shall include:

   1. 1. The following identifying information concerning the individual submitting the request:

      1. a. Name, including any aliases or nicknames;
      2. b. Date of birth;
      3. c. Street and mailing address of current residence;
      4. d. Telephone number;
      5. e. Social Security Number, which information is voluntarily provided in accordance with § 7 of the Privacy Act (5 USC § 552a); and
      6. f. Valid identification credentials containing the individual's signature and a photograph of the individual.

   2. 2. The length of self-exclusion requested by the individual:

      1. a. Two years;
      2. b. Five years; or
      3. c. Lifetime;
   3. 3. An acknowledgment that individuals on the self-exclusion list shall be prohibited from participating in any form of legalized gaming in the Commonwealth and are prohibited from collecting any winnings or recovering any losses resulting from violation of the restrictions to which such individuals have agreed;
   4. 4. An acknowledgment that the department shall coordinate the administration of the self-exclusion program with the Office of Charitable and Regulatory Programs and the Virginia Racing Commission pursuant to procedures developed by the department;
   5. 5. An acknowledgment that the department will share the self-exclusion list with operators of legal gambling in the Commonwealth and that such operators, pursuant to their own policies, may extend the exclusion of the individual to offerings at the operators' locations outside the borders of the Commonwealth;
   6. 6. An acknowledgment that the individual requesting self-exclusion shall notify the department within seven days if the individual's address or other contact information changes; and

   7. 7. A waiver and release that shall release and forever discharge the Commonwealth of Virginia, the department, the department's employees and agents, all holders of permits to operate a sports betting platform and licenses to operate a casino gaming establishment and their employees and agents, the Office of Charitable and Regulatory Programs, and the Virginia Racing Commission and their employees and agents from any liability to the individual requesting self-exclusion, as applicable, and the individual's heirs, administrators, executors, and assigns for any harm, monetary or otherwise, that may arise out of or by reason of any act or omission relating to the request for self-exclusion or request for removal from the self-exclusion list, including:

      1. a. The processing or enforcement of the request for self-exclusion or request for removal from the self-exclusion list;
      2. b. The failure to withhold gaming privileges from or restore gaming privileges to a self-excluded individual;
      3. c. Permitting a self-excluded individual to engage in gaming activity while on the list of self-excluded individuals; and
      4. d. Disclosure of the information contained in the self-exclusion list, except for a willfully unlawful disclosure of such information.

5. E. For self-exclusion submissions for a stated period of time:

   1. 1. A sports betting permit holder or casino gaming establishment shall provide a link directly to the department's self-exclusion application form.

   2. 2. The department's online self-exclusion form shall provide to the self-excluding individual for the individual's acknowledgment the following statement:

      "I am voluntarily requesting exclusion from all Virginia sports betting, casino gaming, and account-based lottery. I also understand that the department will share my information with the Office of Charitable and Regulatory Programs, the Virginia Racing Commission, and all Virginia sports betting permit holders and casino gaming establishments, any of whom may prohibit me from participating in further gaming activities regulated or provided by those entities, including out-of-state sports betting sites or casinos in accordance with the policies of that sports betting permit holder or casino gaming establishment. I agree to notify the department within seven days if my contact information changes. I certify that the information I have provided is true and accurate, and that I have read and understand and agree to the waiver and release included with this request for self-exclusion. I am aware that my digital signature authorizes the department to prohibit me from participating in all account-based lottery games and to direct all holders of sports betting permits and casino gaming establishments in Virginia to restrict my gaming activities. I am further aware that my digital signature authorizes the department to share my information with the Office of Charitable and Regulatory Programs and the Virginia Racing Commission, who may further restrict my gaming activities. In accordance with this request and until such time as the department removes my name from the self-exclusion list under the terms of my request for voluntary self-exclusion, I am aware and agree that during any period of self-exclusion any money obtained by me in violation of the terms of my self-exclusion shall be subject to forfeiture and donated to the Commonwealth's Problem Gambling Treatment and Support Fund."

6. F. For lifetime self-exclusion submissions:

   1. 1. The signature of the individual submitting the request shall acknowledge the following statement:

      "I am voluntarily requesting exclusion from all Virginia sports betting, casino gaming, and account-based lottery. In addition, I understand that my information will be shared with the Office of Charitable and Regulatory Programs, the Virginia Racing Commission, and all Virginia sports betting permit holders and casino gaming establishments, any of whom may prohibit me from participating in further gaming activities regulated or provided by those entities, including out-of-state sports betting sites or casinos in accordance with the policies of that sports betting permit holder or casino establishment. I agree to notify the department within seven days if my contact information changes. I certify that the information I have provided is true and accurate, and that I have read and understand and agree to the waiver and release included with this request for self-exclusion. I am aware that my signature authorizes the department to prohibit me from participating in all account-based lottery games and to direct all holders of sports betting permits and casino gaming establishments in Virginia to restrict my gaming activities. I am further aware that my signature authorizes the department to share my information with the Office of Charitable and Regulatory Programs and the Virginia Racing Commission, who may further restrict my gaming activities. In accordance with this request I am aware and agree that any money obtained by me in violation of the terms of my self-exclusion shall be subject to forfeiture and donated to the Commonwealth's Problem Gambling Treatment and Support Fund."

   2. 2. The department shall document the type of identification credentials that were examined containing the signature of the individual requesting lifetime self-exclusion.

   3. 3. A department employee authorized to accept a self-exclusion request shall sign the application form and confirm that the signature of the individual on the request for lifetime self-exclusion appears to agree with that contained on the individual's identification credentials.

      4 The department shall confirm the individual's request to be placed on the lifetime self-exclusion list.

Statutory Authority

§§ 58.1-4007 and 58.1-4015.1 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 37, Issue 4, eff. October 12, 2020; amended, Virginia Register Volume 38, Issue 24, eff. September 2, 2022.