SKYMILES® ENR OLL MENT F OR M-- ------------ --------------------- ----- ------ ----
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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: [email protected] (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, as a new member, your child can receive mileage credit for flights taken no more
than 30 days prior to enrollment. You may submit that request at delta.com/mileagecredit with their
SkyMiles and ticket numbers. If your child’s SkyMiles number is not provided on future reservations,
retroactive mileage credit can be requested using the same link up to nine months from the date of your
child’s flight.
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
Middle Initial/Name
First Name/Given Name
Suffix
Date of Birth (Month/Day/Year)
Contact Details:
Parent’s Email Address
Please send all SkyMiles communications to:
Home Address
Business 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 ]
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