PINs for VERIFIABLE PARENTAL CONSENT PIN (Personal Identification Number) Application Please read in entirety first. Then fill out and sign to allow your child online privileges on carolgoodrow.com. This application covers all activities on the site. No other permission forms will be needed, unless the activities change. Please check the activities that you give permission for. CONTACT INFORMATION (asterisked items must be filled in). *Child's Name ________________________ Age ____ *Email Address: Child ___________________ or Parent ________________________ *Parent's Phone Number _______________ *Parent's Name ________________________ *Address ___________________________ *City, State, and Zip ___________________ PERMISSION (check items: online submission and publication) Artwork __ Photos __ Stories __ Letters __ Child's Age __ My child may participate in email correspondence with Carol Goodrow (more than one mail) __ Upon receipt of this signed PIN ap, you and your child will receive separate PINs. Please use your PIN in all communication with carolgoodrow.com. Add your PIN to the subject of emails to cgc and include it in postal communication. Please emphasize to your child the importance of not telling anyone his/her PIN. If PINS are lost, you must reapply. I have read the PRIVACY POLICY and would like to receive PINs. *Parent's Signature ______________________ *Date _________ Mail to: Carol Goodrow PO Box 209 Fiskdale, MA 01518