Kabillion.com Parental Consent Form

Please print out this form and fax the signed form to us at 1-818-999-0172.

I give permission for my child ___________________________ to participate in all activities on the www.kabillion.com site, including receiving announcements such as password retrieval, sending and receiving Kabillion.com email, participation in contests and sweepstakes, and posting on and viewing of the Kabillion.com forums. My child is also permitted to sign up with other Kabillion.com sponsors, who help keep Kabillion.com free for our members.

My child's current email address is: _____________________________________________________

  I have read the Kabillion.com Privacy Policy, which provides that Kabillion.com will never share my child's personally identifying information with any third parties. I understand that I can remove my permission with written notice, at any time. I have also read the Kabillion.com legal/privacy policy available @ http://www.kabillion.com/legal/privacy.

Child's Login Name: ____________________________________________ (PLEASE WRITE CLEARLY)

Child's Birthdate: ____________________________________________________________________

State of Child's Residence: ____________________________________________________________

Parent/Guardian Name: _______________________________________________________________

Parent/Guardian Signature: ____________________________________________________________

Relationship to Child: _________________________________________________________________

Date: ________/__________/_________

Please enter your e-mail address in case we need to reach you: ________________________________

Please print out this form and fax it to us at 1-818-999-0172.

Or by mail to: Kabillion.com

Attention: Kabillion Editor
Kabillion LLC.
21300 Oxnard Street, Suite 100
Woodland Hills, California 91367

*If you have any questions regarding the Kabillion.com site or would like to speak with us concerning the sign up process please use this form.