Invisionize - Forums: 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: (+1-)860-646-6816

Mailing Address:
Michael Merritt
Invisionize
101 Crestwood Drive
Manchester, CT 06040 

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 
Signature 
Email Address 
Phone Number 
Date