Please print out this form and fill in the blanks. Then have one of your parents or your legal guardian sign the form where it says "parent signature" and fax it to 509.694.8693 or mail it to Stratagem Corporation at the address below.

After we receive your check or money order, and the form that has been signed by your parent or legal guardian, we will activate your account. Please include your e-mail address so we can notify you that your account has been activated.

Mailing Address:
Stratagem Corporation
80 Nassau Street
Suite 502
New York, NY 10038

Please print legibly! Required information:

Is this account for newHorizone, Second Kingdom or Dreamscape? Please circle one.

First name:_______________________
Last name:_______________________
Mailing address: __________________________
Mailing address:__________________________
City:____________________________ State:___________________________
Zip Code (required):______________
Phone Number (required):___________________________

Please subscribe me to the mailing list: Yes/No (Circle one)

E-mail address (required):_________________________
E-mail address of parent or guardian: _______________________
Gender: male / female
Birthdate (required):________________________

PARENTAL PERMISSION: I hereby grant permission to Stratagem Corporation to register my child for the VZones Community listed above, and to store the personal information of my child on this form in its database.

Signature of Parent or Legal Guardian: ____________________________________

Date: ________________

NOTE TO PARENTS: Stratagem Corporation does not sell or otherwise provide the personal information of anyone under age 18 to any outside third party. We use the information that we collect on this form to keep in touch with registered members of our Web sites, to maintain security on our Web sites and to obtain aggregate demographic data about our members for both internal purposes and for potential advertisers.