Update Your Details Please select your preferred casino. * —Please choose an option—Emperors Palace, JHB, GautengFrontier Inn, Bethlehem Free StateGraceland, Secunda, MpumalangaKhoroni, Thohoyandou, LimpopoMmabatho Palms, Mafikeng, North WestRio, Klerksdorp, North WestSedibeng, Francistown, BotswanaThe Grand Palm, Gaborone, BotswanaThaba Moshate, Burgersfort, LimpopoUmfolozi, Empangeni, KwaZulu-Natal Winners Circle Number * Title * —Please choose an option—MrMrsMissDrProfAdv First name * Surname * Preferred name Type of ID * —Please choose an option—NationalDriversPassportInternational ID number * Date of birth * ⓘ Type birthdate out or click the calendar icon and select Occupation * Are you a foreign or local political exposed person? * YesNo Are you a close associate or a famliy member of a foreign or local political exposed person? * YesNo Source of funds * —Please choose an option—SalarySelf EmployedInheritanceSavingsInvestmentRelatives/FriendsUnemployed Residential address * ⓘ Required by the Financial Intelligence Centre Act 28 of 2001 (FICA) Postal address * ⓘ Required by the Financial Intelligence Centre Act 28 of 2001 (FICA) Code * Code * Contact number (Home) * ⓘ For example 27111234567 Contact number (Work) * ⓘ For example 27111234567 Cellphone number * ⓘ For example 0821234567 Preferred Contact Number Home NumberWork NumberCellphone Number Email Address * Please select your sports interests GolfSoccerRugbyCricketBoxing Please select your music interests Local AfricanLocal AfrikaansLocal EnglishJazz Other (Please specify) Other (Please specify) Please select your entertainment interests DiningSportsTravelOutdoorsTheatre Other (Please specify) In order to receive notifications of your rewards and special offers please indicate your interests:(this is the only way we can let you know what great specials are waiting for you!) * Casino promotionsHotel and Conferencing SpecialsLive Casino games/Sports Betting offersUpcoming Entertainment offers How would you like to receive this information? * EmailTelephoneSMS Terms and Conditions *Additional information may be required from the applicant in terms of legislation. By signing you hereby confirm that you are older than 18 and agree to the terms and conditions at www.peermont.com You hereby authorise the Company , its subsidiaries, affiliates and any authorised third party of the Company to use, review and process any personal information provided to the Company in the course of your relationship with the Company. You understand your right to privacy and the right to have your personal information processed in accordance with the conditions for the lawful processing of personal information and hereby give your consent to the Company, subsidiaries and affiliates to collect, process and distribute relevant personal information where the Company is legally required to do so. Agree to Terms and Conditions *
