Check In Date: Check Out Date: Adults Children

In order for Belterra 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, which can be downloaded for free by Clicking Here.

Once the Request Form is completed, you can submit the form for processing in one of three ways:

1. By mail to address: 777 Belterra Drive Florence, IN 47020
2. By fax to:812.427.7932

3. In person

Click Here to download the Win/Loss Request Form.

Please allow 7 to 10 business days for request processing.

If you have any questions regarding the Win/Loss Request Form please contact us at 888.235.8377 extension 7151.