Win/Loss Request Form

In order for Fitzgeralds to release information regarding your tracked play, you must complete and submit a signed Win-Loss Request Form. To download the Request Form from our site, you must have Adobe Acrobat Reader.

Download Win/Loss form here (PDF).

Once your request form is complete, bring it to Fitzgeralds on your next visit and drop it off at Player Rewards / Main Cashier. You can also mail or fax it to the following address:

Fitzgeralds Casino Black Hawk
P.O. Box 427
Black Hawk, CO 80422-0427
Fax: (303)582-6170 Attn: Marketing

Alternately, you can complete your request by filling out the form below.