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QT-cute: Register / Coppa form

Instructions for a Parent or Guardian. Please print out this page, sign it and mail it to:

phvandenberghe@gmail.com

Philippe Vandenberghe
QT-cute

Permission to participate to the board		Yes		No
Child member Name, firstname
Child member Username
Child member e-mail (if any)
Privacy mode (e-mail visible for)		Members only		Nobody

I have reviewed the information my child has supplied and I have read the Privacy Policy for the web site. I understand that the profile information may be changed by him using a password. I understand that I may ask for this registration profile to be removed entirely.

Parent/Guardian Name, firstname
Relation to child
E-mail address
Phone
Signature and date

If approval is not received within 7 days, the information will be deleted.