CGCC-CH7-06 Self-Exclusion Removal Request 2026

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  1. Click ‘Get Form’ to open the CGCC-CH7-06 Self-Exclusion Removal Request in the editor.
  2. Begin by filling out Section 1: Personal Information. Enter your full name, including last, first, and middle names. If applicable, include any aliases or former legal names.
  3. Provide your current residence address, ensuring to include street, city, state, and ZIP code. If your mailing address differs from your residence, fill that in as well.
  4. Next, input your primary and secondary telephone numbers along with your email address for communication purposes.
  5. In Section 2: Restriction Request, indicate the effective date of exclusion using the MM/DD/YYYY format.
  6. Proceed to Section 3: Declaration. Carefully read each statement and initial where indicated to confirm your understanding and agreement.
  7. Finally, print your name, sign the form, and date it before submitting it as instructed at the top of the document.

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After five years a Self-Excluded person may request removal from the Self-Exclusion List. However, in order to be removed from the Self-Exclusion List, a Self-Excluded person must provide an affidavit from a licensed mental health professional who is also a certified gambling addictions counselor.
The person submitting the request for Self-Exclusion may request to be excluded from gaming activities for a minimum length of one of the following: one year (12 months); five years; or lifetime.
How do I leave the SENSE scheme? After the minimum exclusion period of six months you have the right to be removed from SENSE. You can exercise this right by requesting to leave SENSE at any participating in the SENSE scheme; this does not have to be the where you originally enrolled.
Self-exclusion is a legislated program where a player may wish to exclude himself/herself from gambling activities. In terms of the legislation, anyone can apply for self-exclusion. An individual that is excluded from gambling activities cannot take part in any gambling activity for a period of 6 months.

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