The King's Lottery Gambling Self-Exclusion Form

Charity Name:

Title:

Full Name:

Address:

Postcode:

Email address

Please exclude me from all lottery and raffle activity with immediate effect.

I understand that by submitting this form, the self exclusion will remain in place until I contact you to say that I wish to begin gambling again.

Please note that by law the self-exclusion must apply for a minimum period of 6 months.

Counselling and Support Services

Are you gambling more than you really want to? If you or a family member feel that you are experiencing problems with gambling, you can seek advice and support from trained counsellors at GambleAware by calling the National Gambling Helpline on 0808 8020 133 or visit their website www.GambleAware.org

Software is available to prevent an individual computer from accessing gambling internet sites – please see www.gamblock.com for further information.

Contact Information