If you feel you have a problem with gambling and would like to request that Naomi House & Jacksplace excludes you from all of its gambling related activities, including receiving gambling related marketing materials, you can simply complete and submit the form below.
                
                
                
                I acknowledge that I will not be allowed to rescind my self-exclusion during this period.
                Following our successful completion of your self-exclusion request:
                
                    - Your chosen self-exclusion period will remain in force with Naomi House & Jacksplace, for a minimum of 7 years 
- Naomi House & Jacksplace will not send you any gambling related marketing materials, unless and until you specifically request us to do so.
                    Please ring the Naomi House & Jacksplace Lottery helpline on 01962 826859, 
                    if you wish to extend your chosen self-exclusion period (minimum 6 months extension).
                
                Personal details