Terms you can choose
Not verified: A genuine conflict exists between two official sources. The Bureau's own Self-Exclusion Program page states Self-Restriction periods 'can vary from 30 days, 90 days, 1 year, or lifetime' and are 'dictated by individual cardrooms.' But the Commission's own current model form (CGCC-CH7-04, New 05/20) presents only two checkbox options, ONE YEAR or LIFETIME — no 30- or 90-day option appears anywhere on it. Because a card room may adopt the Commission's form or write its own, the fuller 30/90-day range may still exist at individual properties even though the Commission's own template no longer offers it; this could not be resolved from official sources alone.
When it ends
Not verified.
No source establishes what happens when a Self-Restriction term ends, and no removal form or petition process is published anywhere. The term length itself is disputed between the Bureau's page and the Commission's own model form. A date you write down proves nothing about when this ends — ask the card room holding your record.
How to enroll
Ask the card room for its Self-Restriction form.
There is no statewide submission point for this one. The Bureau's page says plainly that all Self-Restriction forms are kept and maintained inside individual card rooms. Take the form to the card room you are naming. The Commission's Sacramento address printed on the template is its own letterhead contact, and nobody has confirmed it accepts a mailed Self-Restriction form.
- Ask the card room you want to restrict yourself from which form it uses. It may hand you the Commission's template CGCC-CH7-04 (New 05/20), or its own version — the regulation lets it do either.
- Name that card room on the form. The restriction reaches that property and no other.
- Choose what to restrict: total restriction from the establishment, a specific game or gaming activity, check-cashing (in full or to a stated limit), credit (in full or to a stated limit), or marketing and promotional contact.
- Complete your identifying information — legal name and aliases, address, phone, email, the games you play most, your physical description, driver's license or ID number and date of birth — and affix a passport-quality photograph.
- Initial your term and sign. The Commission's current template offers one year or lifetime. The Bureau's page separately describes 30-day, 90-day, one-year and lifetime options set by individual card rooms, so ask what that card room actually offers.
- Hand the completed form to the card room. It keeps and maintains the record itself; no state agency holds a copy.
Official form (CGCC-CH7-04 (New 05/20)) Program page
Before you count on it. This reaches one card room. It is not statewide, and it cannot substitute for the Bureau's statewide list. Two official sources disagree about how long it lasts: the Bureau's page describes 30-day, 90-day, one-year and lifetime terms set by each card room, and the Commission's own current model form offers only one year or lifetime. Because a card room may write its own form, both may be true at different properties — ask the one you are naming. No removal process for a Self-Restriction is published anywhere. Whether the Commission accepts a mailed form at the Sacramento address printed on its template is not established; that address is letterhead, not a submission instruction. Whether someone living outside California may enroll is not established. No receipt or confirmation is published. Hand the completed form to the card room, ask when the restriction takes effect, and write down the date.
Every route we checked
Routes that enroll you
- In person — The specific named card room
The Bureau's page states plainly that 'All Self-Restriction forms are kept and maintained within individual cardrooms' — there is no statewide submission point.
Routes that get you a form or an answer, not an exclusion
- By mail Not verified — State of California, California Gambling Control Commission, 2399 Gateway Oaks Drive, Suite 220, Sacramento, CA 95833-4231
This address appears on the CGCC-CH7-04 form's letterhead as the Commission's own contact information, not as a 'mail completed form to' instruction (unlike the statewide self-exclusion and removal forms, which carry an explicit Bureau P.O. Box mailing instruction). Whether the Commission accepts a mailed self-restriction form as an enrollment route, as opposed to only publishing the optional template, is not established, so this is recorded as an unresolved inquiry-only address rather than an enrollment channel.
Requirements and sources
Sources read 2026-09-24. These are the program's requirements, not a record of anyone's enrollment.
- Terms available
- Not verified: A genuine conflict exists between two official sources. The Bureau's own Self-Exclusion Program page states Self-Restriction periods 'can vary from 30 days, 90 days, 1 year, or lifetime' and are 'dictated by individual cardrooms.' But the Commission's own current model form (CGCC-CH7-04, New 05/20) presents only two checkbox options, ONE YEAR or LIFETIME — no 30- or 90-day option appears anywhere on it. Because a card room may adopt the Commission's form or write its own, the fuller 30/90-day range may still exist at individual properties even though the Commission's own template no longer offers it; this could not be resolved from official sources alone.
- Can a resident enroll
- Not verified: No source addresses residency for self-restriction.
- Can a visitor enroll
- Not verified: No source addresses residency for self-restriction.
- Identification
- Same identification fields as the statewide self-exclusion form: driver's license/ID number, physical description, and an affixed photograph.
- Notarization
- The Commission's template (CGCC-CH7-04) has a signature block headed "NOTARIZATION OR WITNESS BY KEY EMPLOYEE". The Bureau's FAQ says only one or the other is required. A card room is not required to provide a notary (Regulation §12463(b)), and a card room that writes its own form may ask for something different.
- Witnesses
- The CGCC-CH7-04 block lets a key employee of a licensed gambling establishment witness the signature in place of a notary, and the Bureau's FAQ says only one of the two is required. A card room's own form may differ.
- Notarizing online
- Not verified: Notarization itself is not established as required, so remote online notarization does not clearly arise; not addressed by any source.
- How long processing takes
- Not verified: No processing interval is published; each card room runs its own list.
- How you are told it took effect
- Not verified: No confirmation mechanism is published.
The form asks for: name of the specific card room or participating gambling facility the restriction applies to, full legal name, aliases, residence and mailing address, phone numbers, email, games most often played, initialed term selection: one year or lifetime, checked restriction type(s): marketing/promotional, a specific game or gaming activity, check-cashing (or a stated limit), credit (or a stated limit), or total restriction, height, weight, hair color, eye color, driver's license/ID number and state, expiration date, date of birth, race/ethnicity, gender, distinguishing marks, affixed passport-quality photograph, printed name and signature.
- Approved Regulations: Cal. Code Regs. tit. 4, §§12460-12466 (Self-Exclusion and Self-Restriction Programs) cgcc.ca.gov · read 2026-10-21
- Self-Exclusion Program oag.ca.gov · read 2026-09-24
- Self-Restriction Request, CGCC-CH7-04 (New 05/20) cgcc.ca.gov · read 2026-10-21