Larsen Family Public Library

"Better libraries build better communities."

How to Use the Internet

Internet Use Agreement Form

In this case, any child under 18 years of age is considered a minor when using the Internet. This form is intended for the parent(s) or guardian(s) of a minor child to sign after reading the Internet Policies of the Larsen Family Public Library.  No child younger than 18 years of age will be permitted to use the Internet computer without a parent present or an application record and valid permission slip on file.

The Internet Policies are posted near the computers and should be reviewed often by those interested in using these services.

Signature Section:

I have read the Larson Family Public Library Internet Policy and the above guidelines.

I hereby release the library and its personnel from any and all claims and damages of any nature arising from my child’s use of, or inability to use the library system, including, but not limited to, claims arising from the unauthorized use of the system to purchase products or services.

As the parent or legal guardian of the minor child, I give permission for my child to access the Internet for education and information purposes and certify that the information contained in this form is correct.  I will sign this only with a library staff member present at the library location itself.  I will offer to the library personnel proof of identification by way of a driver’s license or picture identification card.

I realize that this form must be on file before my child will be allowed to access the Internet computer at the library.


Child’s Printed Name:

Parent’s Printed Name:

Parent’s Signature:

Home Address:

Home Telephone: