| Lincoln District Scout Band: COPPA Permission Form Instructions for a parent or guardian Please print this form out, complete it and return it to the Secretary, Treasurer, Chairman or Bandmaster of Lincoln District Scout Band. |
| Child's name | |
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Child's email address
You will need to enter a real email address |
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Please sign the form below and return to us. I understand that the information that the child has supplied is correct. I understand that I may ask for the child's email address to be removed from the electronic and printed records held by Lincoln District Scout Band. |
| Parent / Legal Guardian (FULL name) | |
| Relationship to child | |
| Signature | |
| Email Address | |
| Phone Number | |
| Date |
| Form Last Revised 28 August 2007 | LDSB |
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