Public Services – 310F
ST. JOSEPH PUBLIC LIBRARY
INTERNET CONSENT FORM
AUTHORIZING THE USE BY MINORS OF PUBLIC INTERNET COMPUTERS
______________________________________________________________________________
Minors 9 to 17 years of age who wish to access the Internet on St. Joseph Public Library computers must have a parent or legal guardian complete and sign this form.
Information of Minor
Last Name _________________________________ First_______________________________
Library Card Number____________________________________________________________
Signature of minor______________________________________________________________
Date of birth ______________________________ Telephone____________________________
Month Day Year
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
As the parent or legal guardian of the minor named above, I consent to their use of public computers accessing the Internet in any and all facilities of the St. Joseph Public Library.
• I understand that this access can provide many benefits, including research sources, career guidance, and an acquaintance with modern communications technology, not to mention news and entertainment.
• I understand that the public access Internet computers apply some restrictions to minors accessing sites on the Internet, but that there is material available on the Internet that some find to be objectionable and may still be accessible.
• I understand that usage of the public access Internet computers is not continuously monitored by any library personnel and believe that my child can exercise mature judgment, and I take full responsibility for their use and access of Internet sites.
By signing, I am granting permission for my child (9-17 years of age) to access the Internet in the library whether I or another guardian is in attendance or not.
Printed Name (of parent or legal guardian)___________________________________________
Library Card Number (if available) _________________________________________________
Telephone_____________________________________________________________________
Signature of parent or legal guardian_______________________________________________
Date_______________________
Updated June 2023