Company Info | Parents
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I represent and warrant that the information provided below is true and accurate and is provided for the purpose of consenting to my child’s registration with the Site. (Please print legibly.)
Parent's Legal Name: ______________________________________
Parent's Email Address: ___________________________________
Child's Full Name: ________________________________________
Child's Email Address: ____________________________________
Child's Screen Name: ______________________________________
[This must match the screen name provided by the child at registration, and the email address must match the email address provided by the child at registration.]
Parent's Signature: ________________________________________
Submit this Form:
Attention: Parental Consent
Via U.S. Mail:
Her Interactive, Inc.
1150 - 114th Ave. S.E., Ste. 200
Bellevue, WA 98004
NOTE: We are unable to process requests by email unless you attached a digital signature or other digital certificate that uses public key technology to consent via Email. If you do not have a digital signatures that uses public key technology or do not know what that is, please respond by facsimile or U.S. mail.
Please allow a reasonable time for processing of your consent.
Her Interactive complies with the Children’s Online Privacy Protection Act (COPPA). For more information on COPPA see:
COPPA Facts For Parents And Consumers:
Talking With Kids About Being Online:
MESSAGE TO PARENTS
Children under age 13 may not participate in any activities or services offered on the Site which require registration, including the Message Board, without the prior written consent of a parent or legal guardian. Once Her Interactive has obtained consent from the parent or guardian of a minor, we will only ask the child to provide information that is reasonably necessary for participation in the Site’s activities and services.
Any time a child under age 13 registers with the Message Board, or provides Personal Information via the Web site, Her Interactive will send their parent or legal guardian an email containing a Consent Form. You may consent to your child providing Personal Information and/or participating in certain activities and services offered on the Site, by completing and signing the Consent Form, and either faxing the completed Consent Form to Her Interactive at425-460-8788 or mailing the completed form to Her Interactive, Inc., 1150-114th Ave. S.E., Bellevue, WA 98004. No child under age 13 may submit or post Personal Information on or to the Site prior to Her Interactive’s receipt of a Consent Form which provides verifiable consent of a parent or legal guardian.
The parent or legal guardian who has consented to a child registering with the Site and/or providing Personal Information to the Site may later (a) view the child’s Personal Information and correct or remove the information, in whole or in part; (b) instruct Her Interactive to discontinue all use of the child’s Personal Information and/or not to communicate further with the child; or (c) revoke or modify the consent, by contacting Her Interactive at firstname.lastname@example.org and including the child’s name and email address and the parent or guardian’s name and email address, plus any applicable access code provided by Her Interactive.
Children Over Age 13
Children over age 13 may register and participate in activities and services on the Site without the permission of a parent or legal guardian. Her Interactive will use reasonable efforts to respond to requests by parents of children over age 13 regarding their child’s use of the Site.