Fields marked with an asterisk *  are required.


Payment from your personal account is required unless prior arrangements have been authorized by MGM Resorts International or any of it's gaming subsidiaries.

Primary Financial Institution

Secondary Financial Institution

Do you, or any member of your immediate family, presently hold or have you, or any member of your immediate family, previously held a political office?

If yes, what position, in what state/country and over what period of time? Position held   State/Country
Time in the Position: From To

Privacy Statement - In the course of providing credit and other financial services at Borgata, we obtain certain personal and financial information about our customers that may be considered confidential. We maintain physical, electronic and procedural protections to guard our customer's nonpublic personal information. We do not disclose any of this information about our customers or former customers to anyone, except as required by law. In the future it may be necessary to modify or supplement this privacy statement. Our customers will be informed of any changes to our policy in notices that we will provide as required by law.

Customer Agreement - I attorn to the jurisdiction of New Jersey for the purpose of collection of any outstanding debt owing to Borgata. Any partial payment on account of any outstanding debt owing to Borgata shall be deemed an acknowledgement by me of the total remaining balance of the outstanding debt. I certify that I have reviewed all of the information provided above and that it is true and accurate. I authorize Borgata to conduct such investigations pertaining to the above information as deems necessary for the approval of my credit limit. I am aware that this application is required to be prepared by the regulations of the Division of Gaming Enforcement and I will be subject to civil or criminal liability if any material information provided by me is willfully false. I understand that the information provided by me to complete this application is provided for the purpose of inducing Borgata to issue credit to me. I also acknowledge that I have a continuing obligation to advise the Borgata credit staff of any change(s) in the information provided by me as stated herein.

I also certify that I am 21 years of age or older. I understand New Jersey law prohibits person under the agent of 21 from engaging in gaming activity. Accordingly, I must be 21 years of age or older to apply for credit at Borgata. I am aware that false misrepresentation of my age on this application and/or my entry onto the casino floor if I am less than 21 years of age subjects me to criminal prosecution. I hereby authorize Borgata, in its sole discretion, to apply any and all chips, plaques, slot tokens, jackpots, sweepstakes or other cash giveaways that I may win along with any safekeeping deposits may have to be redeemed first to the reduction of my outstanding credit balance with the remainder, if any, to be returned to me. If any counter check in dishonored, interest may be added at 12% annum. I will be responsible for attorney's fees incurred by you pursuing payment from me should I default on my financial obligations to you. Venue for the collection of any dishonored countercheck shall be in Superior Court, Atlantic County, New Jersey. All paid counter checks will be destoyed after 14 days. All cash comps and/or discounts are void if any counter check is dishonored.

I am not an employee of another casino, State officer or employee, a special State officer or employee, or member of the judiciary or member of the legislature, or an officer of a municipality or county in which casino gaming is authorized.


Please verify that you have read and agree to the above disclosures by typing the word YES in the field below.