Duncanville Public Library Internet Consent Form

The undersigned acknowledges that he/she has read and understands and accepts the Duncanville Public Library Internet Policy and Computer Use Guidelines.

Library Patron:

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Signature Print Name

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Address City, State, Zip

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Phone Number Drivers License/Library Card #

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Date

If you have children under 18 and wish for them to use our computer service please read and fill out below:

Parent or Legal Guardian:

By signing below you agree to allow your child to access the Internet stations provided by the Duncanville Public Library. You also agree to all terms and conditions set forth above and you agree that you are fully responsible for your child and any and all the information that your child accesses via the Internet. Children 10 and under must have
their parent sit with them while using library computers.

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Print Child’s Name Age

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Print Child’s Name Age

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Print Child’s Name Age

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Print Child’s Name Age

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Print Child’s Name Age Parent or legal Guardian’s Signature

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Date Print Name