Data Subject Access Request Form

Please fill in the information below. The website administrator will be notified of your request within 24 hours, and will need an appropriate amount of time to respond.

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Name

What email address do you use to access the website

You are submitting this request as(required)

The person, or the parent / guardian of the person, whose name appears above.

An agent authorized by the consumer to make this request on their behalf.

Please leave details regarding your action request or question.

I confirm that(required)

Under penalty of perjury, I declare all the above information to be true and accurate. I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with. I understand that I will be required to validate my request by email, and may be contacted in order to complete the request.

Data Subject Access Request Form

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