Parental Permission Form: Polishing Off Juvenile Diabetes

Parental Permission Form

In compliance with the Children's Online Privacy Protection Act of 1998, we must obtain verifiable parental permission before children under 13 are permitted to post information to this Web site that would identify themselves. Permission must be obtained before a child can post a story on the Submit Your Story Forum.

Process

For parents who have children under the age of 13 and who want to have their child's story included in the Submit Your Story Forum, you must send a letter with the following text to the address below.

[date]
Attn: Web Content Coordinator
Silpada Designs
11550 Renner Blvd.
Lenexa, KS 66219
Phone: (913) 851-7757
Fax: (913) 851-7735

 

I hereby give Silpada Designs' Polishing Off Juvenile Diabetes Campaign permission to include information about my child, [fill in your child's name here], in the Submit Your Story Forum.

I understand that I may revoke this permission at anytime by sending another letter to the address shown above, sending an e-mail to the e-mail address shown above, calling the telephone number shown above, or by sending a fax to the fax number shown above.

 

[sign your name]
[print your name]
[your address]
[your home phone number]
[your e-mail address]

Questions?

If you have any questions about parental permission requirements or your privacy, please contact us.

Last updated on May 18, 2006