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After School Program Registration Form
Please fill out our online registration form to register your child for one of our upcoming programs. We will confirm that your registration has been received through e-mail and send you any additional details that you will need to be aware of.
Name of Program You Are Registering For *
Your answer
Parent/Guardian Name *
Your answer
Email (for program updates) *
Your answer
Parent/Guardian Phone Number (for emergencies) *
Your answer
Child/Children's Name and Ages *
Your answer
Name of program you are registering for *
Your answer
Medical Conditions or Allergies we should be aware of? *
Your answer
Names of people allowed to pick your child up from the program *
Your answer
Emergency Contact Name (if different from above)
Your answer
Emergency Contact Phone Number (if different from above)
Your answer
Additional Contact/Information we should be aware of *
Your answer
Permission to photograph your child. Photographs may be used to promote the library or future programs or for grant/funding applications *
Required
If registering for an Afterschool Program, does your child have permission to ride the bus to the library? *
Required
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