Parental Consent Form

The undersigned parent/guardian hereby grants permission for my child's picture, first name, age and submitted stories to be posted on the web site for Heaven Skates, Inc.  I am also aware that any other personal information about my child, including the full name, mailing address, e-mail address or any other personal information will remain strictly confidential within Heaven Skates, Inc.  No information will be given or sold to any third parties whatsoever without first obtaining my written consent. 

The undersigned also understands that the child's picture, first name, age and submitted stories can be removed from the Heaven Skates, Inc. web site by calling Bill Mohler at 770-387-9699.

Child's name _________________________________________________

Parent/guardian's signature ________________________________________________

Date:_____________________________