As the parent or legal guardian of ___________________________, I hereby consent to have PRIMUS provide him/her with Internet access. I understand that PRIMUS imposes no controls on the information that its users may retrieve from local and remote databases both inside the USA and internationally and that some of this information may be considered objectionable and/or inappropriate for minors.

Signature:_____________________________ Date: _______________

Name:__________________________________

Address: _________________________________________________________________

__________________________________________________________________________

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