ROBOTECH.COM CHILDREN'S MEMBERSHIP PERMISSION FORM

Dear Parent or Legal Guardian,

Your son/daughter would like to become a member of Robotech.com. Robotech.com is a website operated by Harmony Gold and dedicated to the fans of Robotech, a popular animated television show.

Membership at Robotech.com requires personal information, including the following: First name, Last name, a User name, State/province, Country, Email address, Favorite TV network, Age range, Parent's email address, Date of birth, Gender, Occupation, and How they heard about Robotech.com.

In accordance with the Child Online Privacy Protection Act, we at Harmony Gold require that fans under the age of 13 receive their parent's permission to provide us with any personal information and to participate in the website's community activities. As a member, your child will be able to participate in our optional online activities, such as Creating a fan page, Uploading photos of themselves, Posting messages on our forum, and Participating in surveys and contests occasionally.

If you would like to know more about Robotech, you can visit our website at Robotech.com or call Harmony Gold at (323) 851-4900 extension 241. We suggest you read the Kids and Parents/Guardians sections of our online Privacy Policy to understand how we will handle your child's information.

To grant permission for your child to become a member of Robotech.com, to grant permission for your child to participate in the online Robotech.com community, and to grant Harmony Gold permission to gather personal information from them, fill out the following sections and mail it to us at ATTN: Robotech, 7655 Sunset Blvd, Hollywood, CA 90046:

I, (print name)____________________, allow my child, (print name) ____________________, to release his/her personal information to Harmony Gold USA and to participate in the Robotech.com community.

CHILD'S EMAIL ADDRESS (for notification purposes):		____________________________
PARENT'S PHONE NUMBER (for verification purposes):		____________________________

SIGNATURE:		____________________________
DATE:		Month: ____ Day: ____ Year: ____