Parental Consent

Horse Lingo Parental Consent Form

To provide privacy protection for children under the age of 13 and to comply with the Children’s Online Privacy Protection Act (COPPA), Horse Lingo, LLC, an Illinois limited liability company (“we” or “Horse Lingo”) does not knowingly collect or use information or images of minors under the age of 13 without parental consent.  Our Subscribers and Clients must agree that they will not submit to Horse Lingo information or images of any minor under the age of 13 unless we have the consent of that minor’s parent or legal guardian to use that information or those images as part of our Services.  Please review Horse Lingo’s full Privacy Policy to understand how we use the information that is submitted by Subscribers and Clients or that we otherwise collect as part of the Services we provide.

The parent of a child under the age of 13, whose information or image we have received and used as part of the Services, has the right to ask us to remove and delete that information by emailing us at eva@horselingomedia.com.

Authorization

By signing this consent form, I represent and warrant that I am the parent or legal guardian of the minor identified below and appearing in the image(s) accompanying this consent form, that the information provided below is true and accurate, that I have read Horse Lingo’s Privacy Policy, and that I consent to the accompanying image(s) of my child appearing on Facebook®, related mobile app, or other social media as part of the Services provided for the Horse Lingo Subscriber or Client identified below.

Minor’s Name: ___________________________________ Date of Birth: __________________

Name of Horse Lingo Subscriber or Client for which image will appear:  ___________________

______________________________________________________________________________

Description of Accompanying and Permitted Image(s) in which Minor Appears: _____________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Parent/Legal Guardian’s Full Name: ________________________________________________

Parent/Legal Guardian’s Phone Number: _____________________________________________

Parent/Legal Guardian’s Email Address: _____________________________________________

Parent/Legal Guardian’s Full Name: ________________________________________________

Parent/Legal Guardian’s Signature: _________________________________________________

Date Form Is Completed and Signed: _______________________________________________

Resources:

Horse Lingo Privacy Policy: http://www.horselingomedia.com/privacy-policy/

COPPA Facts: http://www.onguardonline.gov/articles/0031-protecting-your-childs-privacy-online

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