New Customer Account Request
This form is used to request an account which will allow you to ADD & REDEEM player credits online & in-store. Once your account is established, you will receive an email with your account details. You can also log into PlayEmpireCity.com to set up your personal account. You will receive a Transaction ID in the confirmation email which will be used each time you make an Add or Redeem Credits Request.
Profile Information
We will set up an account for both Golden Dragon, Fish, & Fortune 2Go online and in-store play.
How did you hear about us?
Who Referred You?
First Name
Last Name
Your Name
*
First Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Email
*
Confirmation Email
Confirm your e-mail address
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Would you like to receive communications via text message. You will receive all promotions, notices about credit Add & Redeem requests, and information on store hours when they change.
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Yes
No
For your Financial Safety & Security - Online Identity Verification Required
Please upload ID (State Issued or School ID). Must be at least 18 to establish an account
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Please upload a picture of you holding your ID for verification.
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Choose a file
We would ordinarily do this in store but since we are online, this is the next best thing. Smile for the camera.
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Please verify that you are human
*
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Redeem Credits Set-Up
Indicate how you would like to redeem your credits. If you need to change this, please contact Empire City directly by visiting https://playempirecity.com.
Select the mode you would like to use to redeem your credits
*
Please Select
PayPal via email (Enter email below)
PayPal via phone (Enter mobile # below)
Zelle via email (Enter email below)
Zelle via phone (Enter mobile # below)
E-check via email (Enter e-mail below)
E-check via paper check (Enter "Paper Check" below)
Cash (No form required - Just head right to the store)
Provide the e-mail or phone number you would like to use to redeem your credits. If. you have selected in-store, type "NA"
*
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We will set up accounts for Golden Dragon and Fortune.
You can add credits during set-up. Just let us know how much you would like to add. This way you can start playing as soon as you get your account information. If you prefer to use Cash App to fund your account just submit the next page and fund your account via $EmpireCityRaleigh.
Would you like to load your account now? If so, you will be redirected to our website where you can make your load request. We will pair that with your new account request. Your account will have credits when you get your login information. otherwise, you can send a request separately.
Load My Account Now using Credit/Debit
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