Polly Paintbrush's Parental Permission Form

Outrageous Originals and Custom Designs

Parental Permission Form

IF YOU ARE UNDER THE AGE OF 13...

A new law says that we must have the permission of your parent or legal guardian, before we can collect your e-mail address. The easiest way to do this would be for us to send your parent or guardian an e-mail requesting their permission.

Please ask your parent or guardian if it's OK for you to provide us with their e-mail address, and we will send them an e-mail to request their permission to collect your e-mail address.

DO NOT COMPLETE THE E-MAIL UPDATE REQUEST FORM UNTIL YOU COMPLETE THIS FORM, AND YOUR PARENT OR GUARDIAN HAS RESPONDED TO OUR REQUEST FOR THEIR PERMISSION. WE WILL SEND YOU AN E-MAIL AFTER WE RECEIVE THEIR PERMISSION.

To have us send your parent or guardian an E-mail...

Click here to view our Privacy Statement and our Notice to Parents

Please note that we will NEVER share your information with ANY third party.

Outrageous Originals and Custom Designs
328 Erickson Road
Ashby MA 01431
Telephone Toll Free : 888-839-9886
E-Mail : polly@pollypaintbrush.com
I accept...

No-Nonsense Web Design like this is available from...
Art Glick dba Almost Heaven Electronics

* = denotes required field

Please note that we will NEVER share your information with ANY third party.