Parental Consent

Please review and complete the information below. Sign your name at the bottom of the form and fax it to The Wichita Eagle at xxx-xxx-xxxx. When The Wichita Eagle receives and processes your consent form, we will activate your child's account. If you have any additional questions, please feel free to call us at The Wichita Eagle.

I, __________________________, hereby certify that I am the parent and/or lawful guardian of ____________________________.

My child's Account Identity is _______________________________. I understand and agree that when my child registers with [paper name] to use its services or participate in its surveys, contests or games, [paper name], or its authorized agents, may collect and maintain certain personal information about my child, including:

• First and last name
• Gender
• Parent's email address
• Birthdate
• Telephone number

I also understand and agree that if my child registers with The Wichita Eagle to win a prize, The Wichita Eagle, or its authorized agents, may collect my child's shipping address in addition to the above-described information.

I further understand and agree that the above-described information will not be disclosed to third parties unless [paper name] has a good faith belief that it is reasonably necessary to comply with the law or to protect the interests of The Wichita Eagle, The McClatchy Company or others; except that such information may be provided to authorized third parties for the purposes of providing the services available on the The Wichita Eagle site or of awarding prizes.

I have read and reviewed the above and the The Wichita Eagle Privacy Policy and I give my permission for The Wichita Eagle to collect, use and disclose personal information about my child in accordance with the terms stated therein.

___________________________________________

Parent's Signature

___________________________________________

Date