PARENTAL CONSENT FORM

To: Vic Firth, Inc.
65 Sprague Street
Boston, MA 02136
Attention: Andrew Tamulynas

Date: ____________________

I understand that information about the activity of visitors to www.vicfirth.com is automatically provided to Vic Firth, Inc. when children and adults sign on. It is used by Vic Firth, Inc. for internal review in aggregate and non-personally-identifiable form. E-mail addresses and other personally identifying data about visitors is known to Vic Firth, Inc. only when voluntarily submitted or posted by visitors to www.vicfirth.com. Vic Firth, Inc. uses personally identifying data provided by a visitor only in connection with his or her use of the site and for Vic Firth, Inc. family promotion, planning and inventory purposes and will not disseminate such data to anyone outside of Vic Firth, Inc. In addition, Vic Firth, Inc. sometimes uses e-mail addresses and other personally identifying information to respond to visitors who communicate with you. For example, Vic Firth, Inc. directs e-mail to visitors who provide you with their e-mail addresses for specific purposes such as responding to an inquiry or notifying users of promotions.

I understand that industry standards for children's sites on the World Wide Web require that I provide to you, the owner/operator of the web site, an informed consent, on behalf of my child or the child for whom I act as legal guardian, before you may collect any personally identifiable information from the child which information may include but not be limited to his or her name, mailing address, e-mail address, telephone number, nickname, or Internet name, as well as products he or she likes to play with or would like to receive information about.

Child May Not Proceed Without Return of Form
I understand that my child may not register with the site, join any clubs on the site, or proceed into certain areas of your Internet site where such personally identifiable information may be requested or collected by you unless and until I return to you this Parental Consent Form with my signature on it.

Grant of Consent
I understand that this Parental Consent Form was obtained by printing the form from www.vicfirth.com and that my child may have secured it on my behalf, but that the signature below is my own true and accurate signature as my child's parent, legal guardian, or the most responsible adult figure above the age of 18 residing in the immediate household of this child. I hereby grant my consent to the collection and transfer of any of my child's personally identifiable information which he or she may provide to you, and I hereby confirm to you that I am at least 18 years of age.

Revocation of Consent Permitted at Any Time
I understand that I may revoke this Parental Consent at any time by going to www.vicfirth.com and printing and returning to Vic Firth, Inc. a Revocation of Parental Consent Form.

All information concerning the child provided below is supplied only for purposes of verification of this form and Vic Firth, Inc. will make no use of it for any other purpose.

Child's name: ________________________

Child's age: ______

"Parent" name [please print carefully or type]: ___________________________________

"Parent" Signature: _________________________

Date:______________

Please return this Parental Consent Form promptly by mailing to the above street address, or by faxing to Vic Firth, Inc., Att. Andrew at 617-364-2571.

If you are submitting this form to enter a child under the age of 13 in a Vic Firth give-away or contest, please provide us with an email address where we may contact you or your child in the event that you are selected as a winner.

Email:________________________

BACK