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Child Privacy Information Request Form (For Children Under 18 Years Old)

Instructions
Please fill in all the fields below, print out form, then fax or send by postal mail.


If you wish to submit this form via fax: Fax: (630) 623-7125

If you wish to submit this form via postal mail:

Privacy at McDonald's
McDonald's Customer Satisfaction Department
One Kroc Drive
Oak Brook, IL. 60523
All Responses will be given via postal mail.

Child Information


Child's First Name:
Child's Last Name:
Child's Logon or Screen Name, if applicable:
Child's Email Address:
Parent Information

Your First Name:
Your Last Name:
Your Postal Address:
Address Line 2:
Your Email Address:
Your Request

Please Delete my child's personal information.
Please Discontinue further use of my child's personal information.
Please Provide me with all personal information you have collected about my child.
Verification
By signing this form, I attest to the fact that I am the parent or legal guardian of the child named above.


_____________________________
(Parent/guardian signature)


_____________________________
(Date)

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