Techsurvivors: 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: 908-236-7333
Coppa Registration Attn: K.D.S. 1 Caldwell Place Warren, NJ 07059
|Enter your desired log in username|
|Enter your Email Address|
|Please sign the form below and send to us.
I understand 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.
|Parent / Legal Guardian FULL name|
|Relation to child|