Permission to Participate at The Ledge
For Those Age 12 And Under

Instructions for a Parent or Guardian

The COPPA permission form may be mailed to:

The Penguin
P.O. Box 571
Piscataway, NJ 08855-0571

Questions should be directed to penguin@fleetwoodmac.net.

Here is the required information supplied with this registration request:

User Name
Password
Email

Information supplied below is optional. Please review it carefully.

City, State, Country
Occupation
Interests
Homepage
Signature
Allow Bulletin Board Administrators and Moderators To Send You Email Notices?
Keep your email address viewable to other users when you post notes?
ICQ Number
   

Please sign the form below and send it to us. [see instructions above]

YES: 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 using a password. I understand that I may ask for this registration profile be removed entirely.

Parent/Guardian Full Name



Signature



Relation to Child



Telephone



Email Address



Date

Online Request Date [available for online registration only]

Please contact penguin@fleetwoodmac.net with any questions

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