Name of participant ____________________
Date of birth ____________________
Driver's license or Illinois Identification Card # ____________________
Address ____________________
________________________________________________________________
Telephone number ____________________
INSTRUCTIONS
1. Do not consume any alcoholic liquor.2. Possess only valid identification.3. If you are asked for identification (ID), show it.4. If an employee, manager or owner of the location asks your age after you have shown your ID, point to the ID and say, "it's right there" or state your actual age.5. If an employee, manager or owner of the location does not ask for your ID but merely asks how old you are, either hand the clerk your ID and say, "it's right there" or state your actual age.6. Do not argue or ask to gamble. Once you have been refused service, the transaction is complete.7. After exiting an establishment with a voucher from a video gaming terminal, transfer the voucher to the designated officer, following procedures established to ensure both proper handling of evidence and confidentiality.8. Immediately record all details of each transaction.9. In no way does your participation in this operation vest in you any authority to perform the duties of a police officer under the laws of the State of Illinois.10. Your signature on this document verifies that you are participating in this operation of your own free will and you are not participating in this operation as a result of any threat made against you or others. I have read and understand the above instructions.
Signature of Participant ____________________
Date ____________________
Ill. Admin. Code tit. 11, pt. 1800, subpt. U, exh. B
Added at 44 Ill. Reg. 11134, effective 6/22/2020