Christina Aguilera Sign-up Permission

Parent/Guardian Permission form for children 13 and under
ONE FORM PER CHILD.

By signing below, you give christina-a.com permission to e-mail your child Christina Aguilera's online newsletter and to obtain information about your child. Christina Aguilera respects the privacy rights of online visitors and recognize the importance of protecting the information collected about your child. We have adopted an Online Privacy Policy that guides how we collect, store and use the information provided to us.

A copy of the Privacy Policy may be found at privacy_policy.html

Please complete the following information to grant your child permission to register for the Christina Aguilera newsletter. Please print information clearly. Once we receive this permission form, your child will receive a "permission granted" e-mail message, which will allow only the child for whom we have received permission to register with the e-mail address, provided below.

Once the registration is complete, your child will receive a "newsletter" and be included in future mailings. Each mailing will provide information on how to remove your child's e-mail address from future mailings. The "permission granted" e-mail should be received within a week of processing of this form.

Child's e-mail address:

________________________________________________________

Child's name: ____________________________________

Child's birth date: (___/___/___/) (month/day/year)

Parent/Guardian name: __________________________________

Parent/Guardian e-mail address:________________________________________________
(optional - required for parent/guardian cc of all messages received by the child)

I would like to get a copy of all e-mail messages my child receives from Christina.
(must provide e-mail address) ____yes ____no

I have given my child permission to receive information on cool products and promotions from Christina
____ Yes ___ No

I have given permission for you to collect further future information on my child.
____ Yes ___ No

Parent/Guardian mailing address (required):

_________________________________________ (street)

_______________________ (city), _____ (state/province) ________

_______ (zip/postal code)

Phone: (____)____-_____ (required)


___________________________________________________________
Parent/Guardian signature and Date

Please mail this form to:
Christina Aguilera's Fan Club
P.O. Box 1425
McAfee, NJ 07428 USA

If, for any reason, you are concerned that the personal information is inaccurate, or should you wish to verify the information we have in our records, please contact by email at [email protected]. We will be happy
to review and update information as appropriate.

Please include with your reply the e-mail address you used to register (child's e-mail address). Also, please be aware that you will need to provide the information to our Online Administrator; to protect your privacy, no specific information we have on file will be given out.

To be removed from our e-mail database, please send an e-mail message to [email protected]. Be sure to include the e-mail address you used to register (child's e-mail).

Thank you again for your interest in Christina Aguilera!

- return to registration page -