Consent to Disclose Contact Information
on Steeplechase website
1. I understand my information on the Steeplechase website can only be accessed with a username and password.
2. I understand this form can be used to refuse having my information posted.
3. I understand this form can be used to rescind my consent.
4. I understand that a record of this consent will be kept on record and a copy made available on request.
The following information can be posted on the Steeplechase website: