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Page Turners' Book Club Registration Form
We are so pleased to welcome you to our Page Turners Book Club. Please fill out this registration form so we get to know you a little better.
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* Indicates required question
Child's Name (include first and last name)
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Your answer
Child's Age
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Your answer
Child's birthday
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MM
/
DD
/
YYYY
Child's Gender
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Male
Female
Parent/Guardian's Name
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Your answer
Parent/Guardian's Email Address
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Your answer
Emergency Contact's Name
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Your answer
Emergency Contact's Phone Number
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Your answer
What school does your child attend?
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Your answer
What grade is your child in?
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Your answer
Does your child have any known allergies ?
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Yes
No
If yes, please state the allergies below.
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Your answer
Does your child have any known medical conditions?
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Yes
No
If yes, please state.
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Your answer
Are there any special needs or accommodations required for your child?
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Your answer
These sessions may be photographed for promotional purposes, do you consent to your child being photographed?
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Yes
No
How did you hear about the Page Turner's Club?
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Kingston Bookshop store
Social Media
Word of mouth
Other:
Would you like to receive updates about future events?
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Yes
No
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