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Click ‘Get Form’ to open the hard rock win loss statement in the editor.
Begin by entering your personal information in the designated fields: Name, Telephone, Date of Birth, Casino, Email Address, and Account Number.
Fill in your Mailing Address along with City, State, and Zip Code. Indicate if this is a change of address by circling 'YES' or 'NO'.
Select the year for which you are requesting a gaming activity statement by circling either 2014 or 2015. Note that current year statements are not provided.
Review the certification statement and ensure all information is accurate before signing. Your signature is required below.
If submitting this request without presenting it in person, ensure your signature is notarized. Attach a valid government-issued photo ID as required.
Submit your completed form at the Backstage Pass Rewards Club Desk or mail it to the specified address for processing.

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