CoolCat Casino
ACCOUNT VERIFICATION FORM
Please enter your username for each of our casinos that you hold and account with:
 
WEBSITE USERNAME WEBSITE USERNAME
CIRRUS CLUBPLAYER
COOLCAT WILD VEGAS
PRISM SLOTS OF VEGAS
VIRTUAL RUBY SLOTS
PARTYCITY PALACE OF CHANCE
Personal Information
Full Name:
Adress:
City: State:
Zip Code: Date of Birth:
Day Phone: Evening Phone:
CARD NUMBER

EXPIRY DATE (MM/YYYY)

Legal Statement

I certify that the electronic media record of my transaction held by the CoolCat Casino shall be used as the final determination to resolve any dispute I may have. I acknowledge that I have read all the information contained in the CoolCat Casino License and agree to abide by all the rules, terms, conditions and agreements therein and as may be amended from time to time.

I also certify that the credit cards listed above have been registered with the CoolCat Casino and used there with my full knowledge and consent.

Signature Date

Return this completed and signed form to us along with a visible copy of your driver's license or other form of official photo I.D. as well as a copy of each credit card used and a utility bill or bank statement with your printed address on.

We will accept these documents by fax or you can also take a digital photograph or scan them and email them to us.

Email: ccprocessing@coolcat-casino.com or creditcards@casinosupportcenter.com

In you have any questions or concerns regarding how your credit card billing will appear, please feel free to send us an email or contact us to our Customer Service Live Help.

Make an imprint of your embossed credit card
1. Place card under the authorization form
2. Rub pencil very light over the card
3.Ensure that name, number, and expiration date are clear and readable.

Use our US Toll Free Fax number: 1-888-879-1302