Please print and submit completed form with application.

P r a i r i e n e t   C o m m u n i t y   N e t w o r k

Permission for Minors to have Adult Access Account

This letter certifies that I ________________________ am the parent or legal guardian of ________________________, who uses the Prairienet login name of: _____________________.

I agree to take full responsibility for all their activities on Prairienet. I recognize that it may be possible to break into other computer systems, illegally access data, or violate network use rules and etiquette, even though Prairienet and all other computer systems take steps to protect against this.

I consent to allow them full access to the Internet. I understand that Prairienet cannot control the quality or appropriateness of materials accessible on the Internet, and acknowledge that material on the Internet may be of an adult nature.

I hold Prairienet harmless for anything that my child/ward may be exposed to or participate in on the Internet, including any data or discussi including any data or discussion which he or she participates in. I have discussed proper ethical network behavior and Internet safety with them, and will help him or her to stay within the bounds of proper and legal behavior.

(if sending this form in the mail, the parent will need to include a photocopy of their driver's license)

Parent or Guardian's Signature: ___________________________________________

Phone Number: ____________________

Date:____________

Please print and submit completed form with application. If the form is being submitted for an existing account, please mail to:

Member Services
Prairienet Community Network
510 E. Daniel
Champaign IL 61821