CreatureBreeder.com COPPA Permission Form Dear parent or guardian: Your child wishes to activate an account on our website, CreatureBreeder.com. In order for a person under 13 years of age to activate certain features of our site, we require this form to be printed, signed, and then emailed or mailed to us. Please discuss the decision to activate an account on CreatureBreeder.com with your child and review our policies before submitting this form. You can read more about our privacy policy at http://creaturebreeder.com/root/privacy_policy . You can read more about the Children's Online Privacy Protection Act (COPPA) at http://coppa.org Please print this form out, complete it, scan the signed form, and then email to the address below: coppa@creaturebreeder.com If you are unable to scan the form, please mail the signed form to the address below: Aemon Cannon 164 Prospect Park West, Apt 2L Brooklyn, NY 11215 USA When we receive this form we will enable those features that are disabled by default for users under thirteen. Specifically: the ability to post comments to the 'farms' of other users. The following information is required to set up an account: User Username: User Email Address: 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 I may ask for this registration profile to be removed. ________________________________________________________ Print Parent / Legal Guardian FULL name ________________________________________________________ Relation to child ________________________________________________________ Signature ______________________ Date