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Royal Rewards Application
ROYAL REWARDS APPLICATION
Please fill out our form to receive your free membership to our Royal Rewards Program.
*
First Name
*
Middle Initial
*
Last Name:
*
Gender:
Male
Female
*
Date of Birth:
[mm/dd/yyyy]
*
Address
*
City:
*
State:
*
Zip Code:
*
Anniversary Date:
(Type N/A if you are not Married)
*
Home Phone:
*
Where have you seen our advertising?
Television
Radio
Billboards
Website
Print/Newspaper
Magazine
Empire Mall
Sioux Falls Sport Events
*
What kind of music are you interested in?
Pop/Top 40
Blues
Big Band
Rock & Roll
Country/Western
Jazz
Classical
*
What type of Casino Games do you prefer?
Slots - Las Vegas Reels
Slots - Digital Video
Blackjack
Live Poker
Off Track Betting
*
What type of promotions interest you?
Vehicle Giveaways
Cash Giveaways
Vacation Getaways
Slot Tournaments
Match Pays
Poker Tournaments
Blackjack Tournaments
Employee Name
Only used for Empire Mall New Player Enrollment.
*E-Mail Address:
Join mailing list?
Yes
No
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