LoanUniverse Community: COPPA Permission Form


Instructions for a parent or guardian

Please print this form out, complete it and fax it to the number specified (if present) or mail to the mailing address below.
Fax Number:
Mailing Address:

Enter your desired log in username                                                                     
                                                                    
Email Address                                                                     

Please sign the form below and send to us.

I understand that I may consent to the collection of necessary information about my child without permitting the site to disclose such information to third parties. I also understand that the site will not collect more information about my child than is reasonably necessary to participate on the site.

I confirm that the information that the child has supplied is correct. I understand that the profile information may be changed by entering a password and I understand that I may ask for this registration profile to be removed. I understand that I can contact the owner of this site at any time to determine what information about my child has been collected, to confirm how that information is used, and to request that the site no longer collect information about my child.

Parent / Legal Guardian FULL name                                                                     
Relation to child                                                                     
Signature                                                                     
Email Address                                                                     
Phone Number                                                                     
Date                                                                     

Admin Reminder
Don't forget to create the account upon receipt of this consent form, and notify the user that their new account is ready for use