2019 Collaborative Summer Library Program
Full name of child
Full name of parent/guardian
Phone number (This number may need to be used in case of an emergency during the Summer Library Program)
Please provide an alternate contact information with phone number in the event of an emergency.
Age of child
Any concerns or information the staff should know about
I plan on participating in the following group
The "Littles" ages 2 - 4 Tuesdays 10:30 - 11:00
"Read to Me" ages 5 - 7 Tuesdays 2:00 - 3:00
"Read with Me" ages 8 - 9 Tuesdays 2:00 - 3:00
"I Read Solo" ages 10 - 12 Tuesdays 3:00 - 4:00
I plan on participating during the following weeks
July 23 Celebration!
All children who register before June 18, 2019 will receive a free Summer Reading Program T-shirt!
Youth S (6-8)
Youth M (8-10)
Youth L (14-16)
Photo Policy: Children and adults participating in the 2019 Collaborative Summer Library Program (CSLP) may be photographed by newspaper or television reporters/photographers, library staff members, or others involved with the program. These photography may appear without compensation in newspapers or in productions, publications, on the web and/or other printed or electronic materials related to the role and function of the Angie W. Cox Public Library.
I give permission to have my child photographed.
I DO NOT give permission to have my child photographed.
Send me a copy of my responses.
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