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COPPA Registration Form
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Please print this form, fill it in and either fax it to the number below or mail it to the provided mailing address.

Fax Number:
 
Mailing Address:
info@pcsx2.net

Account Information

Parent / Guardian Details

I understand that the information I have provided is truthful, that any information may be changed in the future by entering the supplied password and this user account can be removed by request.
Date: