SKYMILES® ENROLLMENT FORM-------------------------------------------------- ------
To enroll your child in SkyMiles, please complete both this enrollment form with your child’s
information and the parent/legal guardian consent form. Be sure to use the same name as it appears on your child’s passport or government ID.
To submit, please return a fully completed, signed copy of the SkyMiles program application and parent/legal guardian consent forms by email or fax to:
Email: SMAssist.delta@delta.com (With subject line: Child application)
Fax: 1-404-773-1945
Once the enrollment has been processed, you will receive an email with your child’s confirmation
and SkyMiles number. Note, you may submit a request for flight credit up to nine months from the date of your child’s flight at delta.com/mileagecredit with their SkyMiles and ticket numbers.
Retroactive credit will be given for flights taken no more than 30 days prior to enrollment.
For questions about submitting the consent form, or to check the status of your request, please see the contact information at the bottom of the consent form below. Please allow 2 business days for processing.
________________________________________________________________________________
Mr. Ms. |
|
Male Female |
_________________________ |
_________________________ |
Last Name/Family Name |
|
First Name/Given Name |
_______________ |
______ |
_________________________ |
Middle Initial/Name |
Suffix |
Date of Birth (Month/Day/Year) |
Contact Details:
_________________________________________________________
Parent’s Email Address
Please send all SkyMiles communications to:
Home AddressBusiness Address (Company Name is required)
_________________________________________________________
Company Name (For business address only)
_________________________________________________________
Street Address
_________________________________________________________
Street Address 2
_________________________ |
_________________________ |
City |
State Province |
_________________________ |
_________________________ |
Zip/Postal Code |
Country |
_________________________ |
_________________________ |
Telephone (Home) |
Telephone (Office) |
_________________________ |
_________________________ |
Telephone (Mobile) |
Fax |
All SkyMiles program rules, available at delta.com, apply to SkyMiles memberships. Visit
delta.com/memberguide for details.
CONSENT OF PARENT OR LEGAL GUARDIAN
We require separate consent from a parent when a child is enrolled in our SkyMiles program. We collect information about children younger than 13 during through this offline application only.
* * *
I hereby certify as follows:
I am the parent or legal guardian of
_____________________________________________________,
(child’s legal name)
who has a birthdate of _____ /_____ /________ .
1.Collection of Information via Offline Application. I have read and understand that enrollment in the Delta SkyMiles program requires the collection, use and potential disclosure of personal information about my child by Delta Air Lines, Inc. as indicated specifically on the attached program Application.
2.Sharing/Use. I understand that under the SkyMiles program, the name, gender, birth date or contact information of SkyMiles Members younger than 13 years of age (“Children”) will not be shared with third parties for promotional purposes, and that Delta does not intentionally send promotional emails to Children.
3.Cookies and other Passively Collected Information. I understand that if someone logs in to my child’s SkyMiles account electronically from a computer or other device connected to the internet,
Delta may passively collect certain non-personally identifiable computer information, such as the type of computer operating system (e.g., Windows XP or Mac OS), the IP Address, the web browser (e.g., Firefox, Internet Explorer) being used, the frequency with which guests visit various parts of our sites, and information regarding the Internet service provider, in order to make our sites more interesting and useful to you and for various purposes related to our business. I have read and understand the Delta Privacy Policy and the Delta Cookies & Privacy policy, available at delta.com, regarding the use of software technologies such as unique identifiers or "cookies." I
hereby consent to the collection, use and potential disclosure of passively collected information while my child’s SkyMiles Account is logged in / signed in from a mobile device or at delta.com.
4.How to Contact Us. I understand that I may contact Delta by using the Email Us page available at www.delta.com or call 1-800-323-2323 if I have questions about my child’s participation in the
SkyMiles program.
Please note that Delta does not send email to SkyMiles members under 13.
_______ By initialing here and signing below, I hereby consent to the collection and use of my child’s personal
information as indicated on the attached Application. I agree, on behalf of myself personally and my child, to be bound by the SkyMiles Terms and Conditions. I consent to my child’s participation in the SkyMiles Program.
AGREEMENT:
SIGNED for and on behalf of my child and myself:
______________________________________ DATED _____ /_____ /________
[ SIGN HERE ]
______________________________________________________
[ PRINT YOUR FULL NAME ]
