In compliance with the Children’s Online Privacy Protection Act (COPPA), parents (or legal guardians) of children under 13 years of age must complete the form. Name First Last Name of Parent/Guardian if under 13 First Last Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Pick your incentiveGizmo Book MagnetBlack and White Paw Key RingOrange Paw Zipper Pull/Dog TagPhone Number of Parent or Guardian if Child is Under Age of 13