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Instructions for a Parent or Guardian

Please print out this page, sign it and email it to:
Emocium

Or mail it to:
ATTN: EMOCIUM
4212 Medical Dr. #711 San Antonio Tx 78229

If approval is not received in 7 days the information will be deleted.

Required Information
Username on Aeonity  
Email Address  
Optional Information
To make changes to the profile information below, please visit this page and enter the username and password:
http://aeonity.com/usercp.php?action=edit_profile
Home Page http:// 
Signature  
Privacy Mode
Selecting 'yes' hides email, ICQ number, AIM ID, Yahoo ID and MSN ID in profile and also hides you in 'Logged In Users' list.
  
ICQ Number  
AIM Screen Name  
Yahoo! Messenger Handle  
MSN Messenger Handle  
Please sign the form below and send it to us.

I have reviewed the information my child has supplied and I have read the Privacy Policy (http://www.aeonity.com/legal) for the web site. I understand that the profile information may be changed by a using a password. I understand that I may ask for this registration profile be removed entirely, I understand and I agree with Aeonity Terms & Agreements...and I do acknowledge that they may be changed at anytime.
Parent / Guardian Full Name  
Relation to Child  
Birthdate of Child  
Telephone Number  
Email Address  
Signature  
Date of Completion  
Please contact the webmaster with any questions that you may have.