Summer Library Program Registration 2018 ~ Lumberton Public Library
All programs are FREE! Please register each individual separately. Be sure to pick up your registration packet at the library on or after May 31, 2018.
Please include address, city, state and zip on one line.
This should be the primary phone. Include area code. Ex: XXX-XXX-XXXX
The library will occasionally take photographs or video of participants in the summer reading program. Check below whether you give permission to the library to use these photographs/videos on the library's web site or in other publicity. *NOTE: If you do not wish for you or your child to be photographed, you will have to keep your child separated from the group and you or your child will have to wear a special sticker on his or her shirt so that staff can clearly see who cannot be photographed.
Yes, I give permission.
No, I do not give permission.
Hold Harmless Statement - Agreement Required
I hereby release Lamar County Library System, its employees and agents from any injury or damage I or my child may suffer as a result of our voluntary participation in this activity and I hereby hold harmless Lamar County Library System, its employees and agents from any and all liability as a result of any injury or damage, of whatever nature, I or my child may suffer as a result of my voluntary participation in this activity.
Do you have any food allergies? If so, please list them.
Never submit passwords through Google Forms.
This form was created inside of Lamar County Library System.
Terms of Service