1000 Books Before Kindergarten
Please fill out 1 form per child.
Child's First and Last Name *
Your answer
Boy or Girl *
Age *
Legal Guardian Name *
Your answer
Phone Number *
Your answer
Are you the legal guardian of this child? *
I, the undersigned, do hereby grant or deny permission to the City of White House & the White House Library to use the image of my child or myself as marked by my selection below. Such uses includes the display, distribution, publication, transmission, or otherwise use of images taken of my child or myself for use in materials that include, but may not be limited to, printed materials, such as newspaper articles, brochures, newsletters, videos, and digital images such as those on any city websites.
Permission *
Check those that apply.
Legal Guardian Signature *
Your answer
Date of Sign Up *
Thank you for signing up your child up for 1000 Books Before Kindergarten! Stop by the library to pick up your 1000 Books material.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service